Prospective study of new-onset seizures in patients with human immunodeficiency virus infection: etiologic and clinical aspects.

Abstract

OBJECTIVE:

To determine the frequency and etiologic and clinical aspects of new-onset seizures in patients with human immunodeficiency virus (HIV) infection.

DESIGN:

A prospective survey of an HIV-infected patient cohort.

SETTING:

Outpatients and inpatients in a university hospital in Barcelona, Spain.

PATIENTS:

Five hundred fifty HIV-infected patients recruited over 1 year.

MAIN OUTCOME MEASURE:

Analysis of new-onset seizures, with detailed medical history and appropriate workup.

RESULTS:

Seventeen HIV-infected patients (3%) had a new-onset seizure during the study period. Fourteen (82%) of 17 patients had acquired immunodeficiency syndrome diagnosed according to the 1993 CDC Expanded AIDS Definition. Mean latency (+/-SD) between diagnosis of HIV infection and the first seizure was 60.7+/-37.6 months. Seizure cause was drug toxicity in 8 patients (47%) and intracranial lesion in 6 patients (35.3%). Two patients had seizures related to metabolic derangements. No cause was found in 1 case. The first seizure was generalized in 12 patients (70.6%), simple partial motor seizure in 2 (11.8%), and simple partial seizure evolving to generalized seizure in 3 (17.6%). We found partial seizures in 66.6% of patients who had intracranial lesions. Most patients were treated with phenytoin, which was well tolerated and effective in controlling seizures.

CONCLUSIONS:

New-onset seizures are infrequent in patients with HIV. In most cases a definite or probable cause is identified, which is usually related to toxic and/or metabolic factors. Most seizures are generalized, and partial seizures suggest a focal cerebral lesion.

• Authors: B Pascual-Sedano, A Iranzo, J Marti-Fàbregas, P Domingo, A Escartin, M Fuster, J L Barrio, M A Sambeat
• Journal: Archives of neurology (Arch Neurol) Vol. 56 Issue 5 Pg. 609-12 (May 1999) ISSN: 0003-9942 [Print] United States
• PMID: 10328257 (Publication Type: Journal Article)

Chemical References

• Anticonvulsants
• Antiviral Agents
• Phenytoin

Topics

• Adult
• Anticonvulsants (therapeutic use)
• Antiviral Agents (adverse effects)
• Cerebral Cortex (pathology)
• Female
• HIV Infections (complications)
• Humans
• Male
• Metabolic Diseases (complications)
• Middle Aged
• Phenytoin (therapeutic use)
• Prevalence
• Prospective Studies
• Seizures (drug therapy, epidemiology, etiology)