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  • Clinical features of seizures after cerebral venous sinus thrombosis and its effect on outcome among Chinese Han population

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Original article
Clinical features of seizures after cerebral venous sinus thrombosis and its effect on outcome among Chinese Han population
  1. Hongyan Ding1,
  2. Yanan Xie1,
  3. Linxin Li2,
  4. Heling Chu1,
  5. Yuping Tang1,
  6. Qiang Dong1,
  7. Mei Cui1
  1. 1 Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
  2. 2 Nuffield Department of Clincial Neurosciences, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr Mei Cui; cuimei{at}fudan.edu.cn

Abstract

Background and purpose Clinical features of epileptic seizures after cerebral venous sinus thrombosis (CVST) among Chinese patients are not known, and it is still controversial whether seizures would affect the outcome of CVST.

Methods In a Chinese hospital-based study of consecutive patients with CVST between 2003 and 2015, we described the clinical features of seizures and determined the predictors of seizure onset using multivariable logistic regression analysis. We also compared the in-hospital case-fatality and short-term functional outcome (modified Rankin Scale (mRS) at discharge) in patients with versus without seizures using ordinal regression analysis.

Results Among 151 patients with CVST, 52 (34.4%) presented seizures, of which 42 (80.8%) were generalised seizures. Male gender (OR 6.32, 95% CI 2.06 to 19.35, p=0.001), motor deficits (OR 4.89, 95% CI 1.52 to 15.68, p=0.008), intracerebral haemorrhage (OR 3.93, 95% CI 1.16 to 13.26, p=0.027), cerebral infarction (OR 3.78, 95% CI 1.15 to 12.36, p=0.029) and superior sagittal sinus thrombosis (OR 3.38, 95% CI 91.16 to 9.86, p=0.026) were independent predictors for seizures. The overall in-hospital case-fatality rate was 2.0% (3/151), and 21 (13.9%) had mRS >2 at discharge. Compared with patients without seizures, patients with seizures were more likely to have a worse outcome (p=0.02) at discharge, independent of age, gender, clinical presentation, clot burden and presence of parenchymal lesions.

Conclusions In Chinese Han patients, compared with patients without seizures, patients with seizures after CVST had a worse outcome. Risk factors such as male gender, paresis, parenchymal lesion and superior sagittal sinus thrombosis were independently associated with seizure onset after CVST. Generalised seizure was the main form of seizures after CVST, which was obviously different to seizures after strokes of arterial origin.

  • cerebral vein thrombosis
  • epileptic seizures
  • risk factors
  • prognosis
  • logistic regression analysis

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/svn-2017-000095

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    Footnotes

    • Contributors HD contributed to study design, literature search, data collection, data analysis, data interpretation and manuscript preparation. YX contributed to study design, literature search, data collection, data analysis, data interpretation and manuscript preparation. LL contributed to data analysis and data interpretation. HC contributed to data collection and data analysis. YT contributed to data collection and data analysis. QD contributed to study design, data interpretation and manuscript preparation. MC contributed to study design, data interpretation and manuscript preparation.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The Institutional Review Board of Huashan Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Unpublished data of our study is under analysing and prepared for another submission. Thus, it is not available now. If any researcher has questions, they can contact with the first author HD (hyding2001@163.com).