Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study

• Published in: Seizure (London, England) Vol. 78; pp. 113 - 117
• Main Authors: Uluduz, Derya, Midi, Ipek, Duman, Taskin, Yayla, Vildan, Karahan, Ali Yavuz, Afsar, Nazire, Goksu, Eylem Ozaydin, Mengulluoglu, Necdet, Aytac, Emrah, Sungur, Mehmet Ali, Yesilot, Nilufer, Ince, Birsen, Yalin, Osman Ozgur, Oruc, Serdar, Senol, Mehmet Guney, Yilmaz, Arda, Gokce, Mustafa, Demirci, Seden, Kusbeci, Ozge Yilmaz, Uzuner, Gulnur, Caglayan, Hale Zeynep Batur, Acikgoz, Mustafa, Kurucu, Hatice, Ozdag, Fatih, Baybas, Sevim, Ekmekci, Hakan, Cabala, Murat, Yaman, Mehmet, Yürekli, Vedat Ali, Tekeli, Hakan, Genc, Hamit, Utku, Uygar, Sahin, Sevki, Tokuc, Firdevs Ezgi Ucan, Uzuner, Nevzat, Bektas, Hesna, Kablan, Yuksel, Goksel, Basak Karakurum, Milanlioglu, Aysel, Orken, Dilek Necioglu, Aluclu, Ufuk, Colakoglu, Sena, Tufekci, Ahmet, Bakar, Mustafa, Nazliel, Bijen, Tascilar, Nida, Goksan, Baki, Kozak, Hasan Huseyin, Demir, Serkan, Mısırli, Cemile Handan, Kucukoglu, Hayriye, Cinar, Nilgun, Domac, Fusun Mayda, Ozturk, Serefnur, Gunes, Taskin
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2020
• Subjects: Adult; Cerebral Hemorrhage - etiology; Cerebral Hemorrhage - physiopathology; Cerebral Infarction - etiology; Cerebral Infarction - physiopathology; Cerebral venous sinus thrombosis; Cerebrovascular disease; Consciousness Disorders - etiology; Consciousness Disorders - physiopathology; Early seizure; Epilepsy; Epilepsy - etiology; Epilepsy - physiopathology; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Prognosis; Prospective Studies; Retrospective Studies; Seizures - etiology; Seizures - physiopathology; Sinus Thrombosis, Intracranial - complications; Sinus Thrombosis, Intracranial - physiopathology; Early seizure; Cerebral venous sinus thrombosis; Epilepsy; Cerebrovascular disease
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2020.02.017

•In our study, approximately one-fourth of patients with CVST had early seizures.•Female sex, presence of focal neurological deficits, altered consciousness were risk factors.•Superior sagittal sinus and cortical veins thrombosis and hemorrhagic infarction were associated with seizures.•The outcome in the first month was worse.•But the long-term prognosis was good in epileptic seizures group. The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.