Epileptic seizures in acute cerebral venous sinus thrombosis: risk factors and effect on outcome

Abstract

Objective To investigate the risk factors of epileptic seizures and its effect on clinical outcome in patients with cerebral venous sinus thrombosis (CVST). Methods The patients with CVST were enrolled retrospectively. The risk factors, clinical manifestations, and imaging data were collected. The data of an epileptic seizure group and a non-epileptic seizure group were compared. Results A total of 69 patients with CVST were enrolled, including 32 (46.38%) secondary epileptic seizures. In the aspect of clinical manifestations, more patients showed hemiplegia in the epileptic seizure group (37.50% vs. 15.63%; χ2=5.240, P=0.020). Imaging examination showed that more patients in the epileptic seizure group presented with bleeding (29.41% vs. 10.81%; χ2=3.818, P=0.047), more lesion involving frontal lobe (31.25% vs. 10.81%; χ2=5.008, P=0.023), and temporal lobe (43.75% vs. 8.11%; χ2=7.318, P=0.005), and the thrombosis sites were more common in the superior sagittal sinuses (65.63% vs. 40.54%; χ2=4.264, P=0.036). Multivariate logistic regression analysis showed that focal neurological deficits (odds ratio 5.167, 95% confidence interval 1.993-15.764; P=0.004) and superior sagittal sinus thrombosis (odds ratio 0.126, 95% confidence interval 0.042-0.370; P=0.039) were the independent risk factors for patients with secondary epileptic seizures. There were no significant differences in hospital mortality (6.25% vs. 2.7%; χ2=0.512, P=0.469) and 90 day 90-day full recovery rate (defined as Barthel Index >60) (81.25% vs. 86.47%; χ2=0.346, P=0.793) between the epileptic seizure group and the non-epileptic seizure group. Conclusions Focal neurologic deficits and superior sagittal sinus thrombosis are the independent risk factors for secondary epileptic seizures, however, secondary epileptic seizures is not associated with in-hospital mortality risk and 90-day clinical outcomes in patients with CVST. Key words: Sinus Thrombosis, Intracranial; Epilepsy; Risk Factors