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

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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.

Original languageEnglish (US)
Article number5547
Pages (from-to)56-60
Number of pages5
JournalNeurology International
Volume6
Issue number4
DOIs
StatePublished - 2014

Keywords

  • CHASE
  • Cognitive impairment
  • Computed tomography
  • Opportunistic infection
  • Prognosis
  • Seizure recurrence

ASJC Scopus subject areas

  • Clinical Neurology

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