title: Risk factors for a first epileptic seizure symptomatic of brain tumour or brain vascular malformation. A case control study.
abstract: BACKGROUND
  The risk of seizures increases in patients with brain tumours (BT) and brain vascular malformations (BVM), but not all risk factors are known. We aimed to identify factors that increase the risk of a first seizure in patients with BT or BVM.
  
  
  METHODS
  Multicentre case-control study; 102 cases with a first seizure as a presenting symptom of BT or BVM; 121 hospital controls with BT or BVM, but without seizures, matched by centre, gender and age.
  
  
  RESULTS
  In the univariate analysis, the risk of first seizure (Odds Ratio, 95% Confidence Limits) was 6.4 (2.3-17.6) for supratentorial lesions, 4.7 (2.4-9.3) for cortical involvement, 2.5 (1.0-7.7) for family history of seizures, and 2.1 (1.2-4.1) for frontal location. The types of lesion with higher risk were low grade glioma (4.7; 1.7-13.9) and cavernous malformations (13.2; 2.1-58.0). After multivariate analysis, including all the imaging characteristics and family history, the strongest independent predictors of first seizure were cortical involvement (OR 4.0; 2.0-8.1) and type of lesion (low grade glioma: 4.0; 1.3-12.8; cavernous malformations: 12.6 (1.5-103.5).
  
  
  CONCLUSIONS
  Cortical involvement and type of lesion are the independent risk factors for a first-ever seizure as a presenting symptom of BT or BVM.
authors.affiliation: Clinica Neurologica, Ospedale Maggiore della Carità, C. Mazzini 18, 28100 Novara, Italy. maurizio.leone@maggioreosp.novara.it
authors.forename: Maurizio A
authors.initials: MA
authors.lastname: Leone
authors.forename: Andrei V
authors.initials: AV
authors.lastname: Ivashynka
authors.forename: Maria C
authors.initials: MC
authors.lastname: Tonini
authors.forename: Graziella
authors.initials: G
authors.lastname: Bogliun
authors.forename: Vittorio
authors.initials: V
authors.lastname: Montano
authors.forename: Carlo
authors.initials: C
authors.lastname: Ravetti
authors.forename: Paola
authors.initials: P
authors.lastname: Gambaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Paladin
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
mesh_terms: D000293:Adolescent; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000503:physiopathology; D016022:Case-Control Studies; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000503:physiopathology; D004827:Epilepsy / Q000209:etiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires