Acute EEG findings in HIV-infected: Zambian adults with new-onset seizure

Omar K. Siddiqi*, Melissa A. Elafros, Izukanji Sikazwe, Gretchen L. Birbeck, Lisa Kalungwana, Michael J. Potchen, Christopher M. Bositis, Igor J. Koralnik, William H. Theodore

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objective: To describe acute EEG findings in HIV-infected adults with new-onset seizure, assess baseline clinical characteristics associated with EEG abnormalities, and evaluate the relationship between EEG abnormalities and recurrent seizure. Methods: Eighty-one HIV-infected adults with new-onset seizure had EEG recordings during their index admission. Baseline characteristics assessed included HIV stage, seizure semiology, serum and CSF studies, neuroimaging, cognitive function based on the Zambian Mini-Mental State Examination and International HIV Dementia Scale, and psychiatric symptoms using the Shona Symptom Questionnaire. We evaluated the relationship between baseline characteristics and EEG abnormalities. Patients were followed for seizure recurrence, and the association between acute EEG abnormalities and seizure recurrence was assessed. Death was a secondary outcome. Results: Fifty-five patients had abnormal EEGs (68%): 18 (22%) had interictal spikes (12) or a recorded seizure (6). Among baseline clinical characteristics, more advanced HIV disease (p = 0.039) and any imaging abnormality (p = 0.027) were associated with abnormal EEGs. Cortical (p = 0.008) and white matter (p = 0.004) abnormalities were associated with slow posterior dominant rhythm. Patients were followed for a median of 303 days (interquartile range 103-560). Twenty-four (30%) died and 23 (28%) had recurrent seizures. EEG abnormalities were not associated with recurrent seizure. There was a nonsignificant association between seizures recorded during EEG and death (67% vs 26%, p = 0.051). Conclusions: EEG abnormalities are common in this population, particularly in patients with imaging abnormalities and advanced HIV. Acute EEG abnormalities were not associated with recurrent seizure, but high mortality rates during follow-up limited this analysis.

Original languageEnglish (US)
Pages (from-to)1317-1322
Number of pages6
JournalNeurology
Volume84
Issue number13
DOIs
StatePublished - Mar 31 2015

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint Dive into the research topics of 'Acute EEG findings in HIV-infected: Zambian adults with new-onset seizure'. Together they form a unique fingerprint.

  • Cite this

    Siddiqi, O. K., Elafros, M. A., Sikazwe, I., Birbeck, G. L., Kalungwana, L., Potchen, M. J., Bositis, C. M., Koralnik, I. J., & Theodore, W. H. (2015). Acute EEG findings in HIV-infected: Zambian adults with new-onset seizure. Neurology, 84(13), 1317-1322. https://doi.org/10.1212/WNL.0000000000001411