title: Seizures in primary antiphospholipid syndrome: the relevance of smoking to stroke.
abstract: OBJECTIVE
  To evaluate the frequency of seizures in primary antiphospholipid syndrome (PAPS) and their possible clinical and laboratory associations.
  
  
  METHODS
  Eighty-eight PAPS patients (Sydney's criteria) were analyzed by a standard interview, physical examination and review of medical charts. Risk factors for seizures, clinical manifestations, associated comorbidities, and antiphospholipid antibodies were evaluated.
  
  
  RESULTS
  Nine (10.2%) patients with seizures were identified, 77.8% had convulsions onset after PAPS diagnosis. Mean age, gender, and race were comparable in groups with or without seizures. Interestingly, a higher frequency of current smoking (44.4 versus 10.1%, P = 0.019) was observed in the first group. Stroke, Sneddon's syndrome, and livedo reticularis were more frequent in PAPS patients with seizures than those without seizures, although not statistically significant (P > 0.05). Comparison between patients with seizures onset after PAPS diagnosis (n = 7) and those without convulsions (n = 79) demonstrated a higher frequency of current smoking (42.9 versus 10%, P = 0.042) and stroke in the first group (71.4 versus 30.4%, P = 0.041). Regression analysis confirmed that smoking (P = 0.030) and stroke (P = 0.042) were independently associated to seizures.
  
  
  CONCLUSIONS
  About 10.2% of PAPS patients had convulsions, predominantly after PAPS diagnosis, and seizures were associated to current smoking and stroke.
authors.affiliation: Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 01246-903 São Paulo, SP, Brazil. jotafc@gmail.com
authors.forename: Jozélio Freire
authors.initials: JF
authors.lastname: de Carvalho
authors.forename: Sandra Gofinet
authors.initials: SG
authors.lastname: Pasoto
authors.forename: Simone
authors.initials: S
authors.lastname: Appenzeller
mesh_terms: D000328:Adult; D017668:Age of Onset; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012640:Seizures / Q000097:blood / Q000503:physiopathology*; D012907:Smoking / Q000009:adverse effects*; D018860:Sneddon Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D020521:Stroke / Q000097:blood / Q000209:etiology* / Q000503:physiopathology
chemical_list: D017152:Antibodies, Antiphospholipid