Seizures risk factors in sickle cell disease. The cooperative study of sickle cell disease

Abstract

IntroductionAlthough evidence suggests that neurological complications, including seizures and epilepsy, are more common among sickle cell disease (SCD) patients, few studies have assessed the risk factors of developing seizures among SCD patients MethodsWe used a nested case–control study design to compare pediatric and adult SCD patients who experienced seizures with patients who did not experience any seizure regarding clinical and laboratory parameters. We conducted a secondary analysis using the data from the Cooperative Study of Sickle Cell Disease in this study ResultsThere were 153 out of 2804 (5.5%) pediatric patients who had seizures with a median age of 8.5 (Interquartile range [IQR] = 10.1) years at first seizure and 115 out of 1281 (9.0%) adult patients who had seizures with a median age of 28.0 (IQR = 10.6) years at first seizure. Cerebrovascular accident ([CVA], OR = 5.7, 95% CI = 2.9–11.0), meningitis (OR = 3.6, 95% CI = 1.8–7.2), and eye disease (OR = 3.4, 95% CI = 1.5–8.0) were associated with increased risk of developing seizures among pediatric patients. While CVA (OR = 7.5, 95% CI = 3.5–16.0), meningitis (OR = 5.6, 95% CI = 1.5–20.0), nephrotic syndrome (OR = 3.0, 95% CI = 1.2–7.9), spleen sequestration (OR = 2.7, 95% CI = 1.1–6.3), and pneumonia (OR = 2.1, 95% CI = 1.0–4.4) were associated with increased risk of developing seizures among adult patients ConclusionThese findings suggest the need for treatment optimization and regular neurological follow up for SCD patients with these identified risk factors to prevent the development of seizures.