The factors related to epileptic seizures in cerebral venous sinus thrombosis in southern China: A retrospective, multicenter, self-controlled study

Objective

To investigate the risk factors for and prevention of seizures in cerebral venous sinus thrombosis patients.

Methods

This retrospective study included 216 patients with cerebral venous sinus thrombosis (CVST) from 3 hospitals in southern China from January 2010 to October 2020. Patients were divided into 2 groups comprising patients with and without early seizures (within 14 days of the diagnosis of CVST). The early seizure group was divided into 2 subgroups: those with late seizures (after 14 days of CVST diagnosis) and those without seizures. The non-early seizure group was also divided into 2 subgroups. The different groups were analyzed and compared in terms of demographics, laboratory indices, imaging data and the use of antiseizure medications (ASMs).

Results

A total of 216 patients with CVST were included in the study, including 33 patients in the early seizure group and 183 patients in the non-early seizure group. In this study, 9 (27.3 %) patients in the early seizure group and only 8 patients in the non-early seizure group experienced late seizures, and the difference in the incidence of late seizures between the two groups reached statistical significance (p < 0.05, 9/33 vs. 8/183). Univariable analysis revealed statistically significant differences in d-dimer levels (P = 0.030), parenchymal lesions (P = 0.008), intracranial hemorrhage (P < 0.001), superior sagittal sinus involvement (P = 0.003), and cortical venous involvement (P = 0.003) between the early seizure group and the non-early seizure group. Logistic regression analysis revealed that intracranial hemorrhage (P = 0.005, OR=6.303, 95 % CI 1.732–22.941) may be one of the risk factors for early seizures. There was no univariate difference between the late seizure subgroup in the early seizure group and the late seizure subgroup in the non-early seizure group, except for the involvement of three venous sinuses.

Conclusions

Patients with CVST who have early seizures are more likely to have late seizures than those who do not have early seizures. Intracranial hemorrhage may be one of the risk factors for early seizures. The risk factors for late seizures need to be identified in future clinical studies. There is insufficient evidence that the use of ASM prevents early seizures from progressing to late seizures.