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Arch Neurol. 1999 May;56(5):609-12.

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

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  • 1Department of Neurology, Hospital de Sant Pau, Barcelona, Spain.

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.

PMID:
10328257
[PubMed - indexed for MEDLINE]
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