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Predictors of seizures in patients with cerebral venous thrombosis in the Thai population: A retrospective study

  • Thanyalak Amornpojnimman
    Affiliations
    Division of neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
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  • Wiwit Mitarnun
    Affiliations
    Division of neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
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  • Pat Korathanakhun
    Correspondence
    Corresponding author at: Neurology unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
    Affiliations
    Division of neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
    Search for articles by this author
Published:January 09, 2022DOI:https://doi.org/10.1016/j.seizure.2022.01.005

      Highlights

      • Intracerebral haemorrhage and initial dependency status predict seizure in CVT.
      • Seizure may increase mortality in CVT.
      • Focal to bilateral tonic-clonic seizure was the most common seizure type.

      Abstract

      Purpose

      This study aimed to define independent factors associated with the onset of early seizure (ES) amongst patients with cerebral venous thrombosis (CVT).

      Methods

      This retrospective cohort study recruited patients diagnosed with CVT and hospitalised between 2002 and 2020. Demographic, clinical, and seizure characteristics; neuroimaging findings; and clinical outcomes were compared between the seizure and non-seizure groups. Factors with p-values of <0.05 in univariate analysis were included in multivariate logistic regression analysis to determine independent predictors of ES.

      Results

      Amongst 180 CVT patients, the incidence of ES was 38.3%. Most seizures presented as the initial symptom. Focal to bilateral tonic-clonic seizure was the most common seizure type (82.6%). Recurrent serial seizure and non-fatal status epilepticus accounted for 56.5% and 8.7% cases, respectively. Intracerebral haemorrhage (adjusted odds ratio [aOR]=6.57, 95% confidence interval [CI], 2.25‒19.21, p = 0.001) and dependency status at admission (aOR=3.32, 95% CI, 1.08‒10.18, p = 0.036) independently predicted ES, whereas isolated increased intracranial pressure (aOR=0.05, 95% CI, 0.01‒0.24, p < 0.001), isolated headache (aOR=0.10, 95% CI, 0.02‒0.45, p = 0.002), straight sinus thrombosis (aOR=0.03, 95% CI, 0.00‒0.37, p = 0.007), and cavernous sinus thrombosis (aOR=0.50, 95% CI, 0.01‒0.53, p = 0.012) showed protective effects.

      Conclusion

      Intracerebral haemorrhage and dependency status at admission independently predicted seizures, whereas isolated increased intracranial pressure, isolated headache, straight sinus thrombosis, and cavernous sinus thrombosis showed preventive effects.

      Keywords

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      References

        • Ferro J.M.
        • Canhão P.
        • Stam J.
        • Bousser M.G.
        • Barinagarrementeria F.
        • Investigators I.S.C.V.T.
        Prognosis of cerebral vein and dural sinus thrombosis. Results of the international study on cerebral vein and dural sinus thrombosis (ISCVT).
        Stroke. 2004; 35: 664-670
        • Botta R.
        • Donirpathi S.
        • Yadav R.
        • Kulkarni G.B.
        • Kumar M.V.
        • Nagaraja D.
        Headache patterns in cerebral venous sinus thrombosis.
        J Neurosci Rural Pract. 2017; 8: S72-S77
        • Kalita J.
        • Chandra S.
        • Misra U.K.
        Significance of seizure in cerebral venous sinus thrombosis.
        Seizure. 2012; 21: 639-642
        • Ding H.
        • Xie Y.
        • Li L.
        • Chu H.
        • Tang Y.
        • Dong Q.
        • et al.
        Clinical features of seizures after cerebral venous sinus thrombosis and its effect on outcome among Chinese Han population.
        Stroke Vasc Neurol. 2017; 2: 184-188
        • Davoudi V.
        • Keyhanian K.
        • Saadatnia M.
        Risk factors for remote seizure development in patients with cerebral vein and dural sinus thrombosis.
        Seizure. 2014; 23: 135-139
        • Sha D.J.
        • Qian J.
        • Gu S.S.
        • Wang L.N.
        • Wang F.
        • Xu Y.
        Cerebral venous sinus thrombosis complicated by seizures: a retrospective analysis of 69 cases.
        J Thromb Thrombolysis. 2018; 45: 186-191
        • Ferro J.M.
        • Canhão P.
        • Bousser M.G.
        • Stam J.
        • Barinagarrementeria F.
        • Investigators I.S.C.V.T.
        Early seizures in cerebral vein and dural sinus thrombosis: risk factors and role of antiepileptics.
        Stroke. 2008; 39: 1152-1158
        • Uluduz D.
        • Midi I.
        • Duman T.
        • Yayla V.
        • Karahan A.Y.
        • Afsar N.
        • et al.
        Epileptic seizures in cerebral venous sinus thrombosis: subgroup analysis of VENOST study.
        Seizure. 2020; 78: 113-117
        • Duman T.
        • Yayla V.
        • Uludüz D.
        • Özaydın Göksu E.
        • Yürekli V.A.
        • Genç H.
        • et al.
        Assessment of patients with intracerebral haemorrhage or haemorrhagic transformation in the VENOST study.
        Eur Neurol. 2020; 83: 615-621
        • Stolz E.
        • Rahimi A.
        • Gerriets T.
        • Kraus J.
        • Kaps M.
        Cerebral venous thrombosis: an all or nothing disease? Prognostic factors and long-term outcome.
        Clin Neurol Neurosurg. 2005; 107: 99-107
        • Wasay M.
        • Kaul S.
        • Menon B.
        • Dai A.I.
        • Saadatnia M.
        • Malik A.
        • et al.
        Asian study of cerebral venous thrombosis.
        J Stroke Cerebrovasc Dis. 2019; 28104247
        • Kalita J.
        • Misra U.K.
        • Singh V.K.
        • Dubey D.
        Predictors and outcome of status epilepticus in cerebral venous thrombosis.
        J Neurol. 2019; 266: 417-425
        • Stokum J.A.
        • Cannarsa G.J.
        • Wessell A.P.
        • Shea P.
        • Wenger N.
        • Simard J.M.
        When the blood hits your brain: the neurotoxicity of extravasated blood.
        Int J Mol Sci. 2021; 22: 5132
        • Shtaya A.
        • Bridges L.R.
        • Esiri M.M.
        • Lam-Wong J.
        • Nicoll J.A.R.
        • Boche D.
        • et al.
        Rapid neuroinflammatory changes in human acute intracerebral haemorrhage.
        Ann Clin Transl Neurol. 2019; 6: 1465-1479
        • Hunt R.F.
        • Boychuk J.A.
        • Smith B.N.
        Neural circuit mechanisms of post-traumatic epilepsy.
        Front Cell Neurosci. 2013; 7: 89
        • Wang J.
        • Doré S.
        Heme oxygenase-1 exacerbates early brain injury after intracerebral haemorrhage.
        Brain. 2007; 130: 1643-1652
        • Lyden P.D.
        • Lu M.
        • Levine S.R.
        • Brott T.G.
        • Broderick J.
        NINDS rtPA Stroke Study Group. A modified National Institutes of Health stroke scale for use in stroke clinical trials: preliminary reliability and validity.
        Stroke. 2001; 32: 1310-1317