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. 2014 Oct 23;6(4):5547.
doi: 10.4081/ni.2014.5547.

Neuroimaging abnormalities and seizure recurrence in a prospective cohort study of zambians with human immunodeficiency virus and first seizure

Michael J Potchen  1 , Omar K Siddiqi  2 , Melissa A Elafros  3 , Igor J Koralnik  4 , William H Theodore  5 , Izukanji Sikazwe  6 , Lisa Kalungwana  7 , Christopher M Bositis  8 , Gretchen L Birbeck  9
Affiliations

Neuroimaging abnormalities and seizure recurrence in a prospective cohort study of zambians with human immunodeficiency virus and first seizure

Michael J Potchen et al. Neurol Int. .

Abstract

In HIV-positive individuals with first seizure, we describe neuroimaging findings, detail clinical and demographic risk factors for imaging abnormalities, and evaluate the relationship between imaging abnormalities and seizure recurrence to determine if imaging abnormalities predict recurrent seizures. Among 43 participants (mean 37.4 years, 56% were male), 16 (37%) were on antiretroviral drugs, 32 (79%) had advanced HIV disease, and (28) 66% had multiple seizures and/or status epilepticus at enrollment. Among those with cerebrospinal fluid studies, 14/31 (44%) had opportunistic infections (OIs). During follow-up, 9 (21%) died and 15 (35%) experienced recurrent seizures. Edema was associated with OIs (odds ratio: 8.79; confidence interval: 1.03-236) and subcortical atrophy with poorer scores on the International HIV Dementia Scale) (5.2 vs. 9.3; P=0.002). Imaging abnormalities were not associated with seizure recurrence or death (P>0.05). Seizure recurrence occurred in at least a third and over 20% died during follow-up. Imaging was not predictive of recurrent seizure or death, but imaging abnormalities may offer additional diagnostic insights in terms of OI risk and cognitive impairment.

Keywords: CHASE; cognitive impairment; computed tomography; opportunistic infection; prognosis; seizure recurrence.

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Conflict of interest statement

Conflict of interests: the authors declare no potential conflict of interests.

References

    1. Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2007;69:1996-2007. - PubMed
    1. Birbeck GL, French JA, Perucca E, et al. Evidence-based guideline: antiepileptic drug selection for people with HIV/AIDS: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Ad Hoc Task Force of the Commission on Therapeutic Strategies of the International League Against Epilepsy. Neurology 2012;78:139-45. - PMC - PubMed
    1. Pesola GR, Westfal RE. New-onset generalized seizures in patients with AIDS presenting to an emergency department. Acad Emerg Med 1998;5:905-11. - PubMed
    1. Ortblad KF, Lozano R, Murray CJ. The burden of HIV: insights from the Global Burden of Disease Study 2010. AIDS 2013;27:2003-17. - PMC - PubMed
    1. WHO/WFN. Atlas: country resources for neurological disorders. Geneva: WHO; 2004. p 59.

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