Predictors and long-term outcome of seizures after bacterial brain abscess.
BACKGROUND
Seizures are one of the most important neurological complications of bacterial brain abscesses. A better understanding of the risk factors of seizures following bacterial brain abscesses is needed to predict those who will require treatment.


METHODS
A total of 205 patients were enrolled in this 22-year retrospective study. Prognostic variables were analysed based on Cox's proportional hazards model after a minimum of 18 months of follow-up.


RESULTS
Seizures occurred in 48 patients who had bacterial brain abscesses, including acute symptomatic seizures in 17% (35/205) and unprovoked seizures in 6.4% (13/205). Altogether, 27 patients had early seizures and 21 had late seizures. The overall mortality rate in the seizure patients was 23% (11/48) and seven patients progressed to epilepsy.


CONCLUSIONS
Cox's proportional hazards model demonstrated that valvular heart diseases as the underlying diseases and the presence of a fronto-parietal distribution of bacterial brain abscess were independently predictive of seizures, and the presence of late seizures was predictive of developing epilepsy. Most first seizures occurred within 3 y after bacterial brain abscesses.
Chuang
Ming-Jung
MJ
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang
Wen-Neng
WN
Chang
Hsueh-Wen
HW
Lin
Wei-Che
WC
Tsai
Nai-Wen
NW
Hsieh
Mei-Jen
MJ
Wang
Hung-Chen
HC
Lu
Cheng-Hsien
CH
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D001922:Brain Abscess / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D005260:Female; D015600:Glasgow Coma Scale; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome