Late seizures in cerebral venous thrombosis.

Sánchez van Kammen, Mayte; Lindgren, Erik; Silvis, Suzanne M; Hiltunen, Sini; Heldner, Mirjam Rachel; Serrano, Fabiola; Zelano, Johan; Zuurbier, Susanna M; Mansour, Maryam; Aguiar de Sousa, Diana; Canhão, Patrícia; Al-Asady, Saleem; Ekizoglu, Esme; Redfors, Petra; Yesilot, Nilufer; Ghiasian, Masoud; Barboza, Miguel A; Arnao, Valentina; Aridon, Paolo; Punter, Martin N M; ... (2020). Late seizures in cerebral venous thrombosis. Neurology, 95(12), e1716-e1723. American Academy of Neurology 10.1212/WNL.0000000000010576

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OBJECTIVE

To examine the incidence, characteristics, treatment, and predictors of late seizures (LS) after cerebral venous thrombosis (CVT), we described these features in a registry of 1,127 patients with CVT.

METHODS

We included consecutive adult patients from an international consortium of 12 hospital-based CVT registries. We excluded patients with a history of epilepsy or with <8 days of follow-up. We defined LS as seizures occurring >7 days after diagnosis of CVT. We used multivariable Cox regression to identify predictors of LS.

RESULTS

We included 1,127 patients with CVT. During a median follow-up of 2.0 years (interquartile range [IQR] 1.0-6.3), 123 patients (11%) experienced ≥1 LS (incidence rate for first LS 30 per 1,000 person-years, 95% confidence interval [CI] 25-35). Median time to first LS was 5 months (IQR 1-16 months). Baseline predictors of LS included status epilepticus in the acute phase (hazard ratio [HR] 7.0, 95% CI 3.9-12.6), decompressive hemicraniectomy (HR 4.2, 95% CI 2.4-7.3), acute seizure(s) without status epilepticus (HR 4.1, 95% CI 2.5-6.5), subdural hematoma (HR 2.3, 95% CI 1.1-4.9), and intracerebral hemorrhage (HR 1.9, 95% CI 1.1-3.1). Eighty-five patients (70% of patients with LS) experienced a recurrent seizure during follow-up, despite the fact that 94% received antiepileptic drug treatment after the first LS.

CONCLUSION

During a median follow-up of 2 years, ≈1 in 10 patients with CVT had LS. Patients with baseline intracranial bleeding, patients with acute symptomatic seizures, and those who underwent decompressive hemicraniectomy were at increased risk of developing LS. The high recurrence risk of LS justifies epilepsy diagnosis after a first LS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
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UniBE Contributor:

Heldner, Mirjam Rachel and Arnold, Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1526-632X

Publisher:

American Academy of Neurology

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

10 Nov 2020 08:50

Last Modified:

10 Nov 2020 08:57

Publisher DOI:

10.1212/WNL.0000000000010576

PubMed ID:

32759195

BORIS DOI:

10.7892/boris.147380

URI:

https://boris.unibe.ch/id/eprint/147380

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