Introduction

Acute symptomatic seizures (ASS) are seen in one-third of cerebral venous sinus thrombosis (CVT) cases either as the presenting symptom or shortly after diagnosis in the acute phase. The goal of our study was to assess the trends in recognition of ASS in CVT over the years and to determine factors predictive of ASS in the patients with CVT for early identification of candidates who would benefit from anti-seizure medications (ASM).

Materials and methods

The Nationwide Inpatient Sample (NIS) database was accessed to identify adult inpatient admissions with a primary or secondary diagnosis of CVT. Comorbidities, complications, risk factors, and procedures pertaining to these hospitalizations were compared between CVT patients with and without ASS.

Results

A total of 53,710 CVT-related hospitalizations were identified, of which 18.1% of patients had a burden of ASS at presentation or subsequently during hospitalization. CVT patients with ASS had a longer average duration of hospitalization and higher overall morbidity and mortality.

Conclusions

Our study showed ~one in five patients (18.1%) with CVT had ASS. ASS patients had higher odds of mortality and disability at discharge, requiring post-discharge rehabilitation care. It is crucial to identify risk factors of ASS in the CVT population to avoid future preventable revisit related to seizures. Additional research is required for risk stratification of patients with CVT for primary and secondary seizure prophylaxis and determining the appropriate choice and duration of ASM in these patients.

中文翻译：

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脑静脉窦血栓形成中急性症状性癫痫发作的负担：美国全国分析

介绍

在三分之一的脑静脉窦血栓形成 (CVT) 病例中可以看到急性症状性癫痫发作 (ASS)，无论是作为就诊症状还是在急性期诊断后不久。我们研究的目的是评估多年来在 CVT 中识别 ASS 的趋势，并确定 CVT 患者中 ASS 的预测因素，以便及早识别将从抗癫痫药物 (ASM) 中受益的候选人。

材料和方法

访问全国住院患者样本 (NIS) 数据库，以确定主要或次要诊断为 CVT 的成人住院患者。在有和没有 ASS 的 CVT 患者之间比较了与这些住院有关的合并症、并发症、危险因素和程序。

结果

共确定了 53,710 例 CVT 相关住院，其中 18.1% 的患者在就诊时或住院期间有 ASS 负担。患有 ASS 的 CVT 患者平均住院时间更长，总体发病率和死亡率更高。

结论

我们的研究表明，大约五分之一的 CVT 患者（18.1%）患有 ASS。ASS 患者出院时死亡率和残疾的几率更高，需要出院后的康复护理。识别 CVT 人群中 ASS 的危险因素对于避免未来与癫痫发作相关的可预防重访至关重要。CVT患者的风险分层需要额外的研究，用于次级和次级癫痫发作预防，并确定这些患者中适当的ASM选择和持续时间。