title: Risk factors for remote seizure development in patients with cerebral vein and dural sinus thrombosis.
abstract: OBJECTIVE
  We aimed to define the possible risk factors for acute and remote seizures in patients with cerebral vein and sinus thrombosis (CVST).
  
  
  METHODS
  Ninety-four patients were recruited prospectively at Al-Zahra Hospital, Isfahan, Iran, between April 2007 and April 2012. To identify seizure predictors, we compared demographic, clinical and imaging factors between patients with or without acute and remote seizures.
  
  
  RESULTS
  Of the 94 patients, 32 (34%) experienced at least one seizure after CVST development. Bivariate analysis showed a significant association of remote seizure with loss of consciousness at presentation (P=0.05, OR: 5.11, 95%CI: 1.07-24.30), supratentorial lesions (P=0.02, OR: 9.04, 95%CI: 1.04-78.55), lesions in the occipital lobe (P=0.00, OR: 12.75, 95%CI: 2.28-71.16), lesions in the temporal and parietal lobes, thrombophilia (P=0.03, OR: 5.87, 95%CI: 1.21-28.39), seizure in the acute phase (P=0.00, OR: 13.14, 95%CI: 2.54-201.2) and sigmoid sinus thrombosis (P=0.00, OR: 12.5, 95%CI: 2.23-69.79). Seizures in the acute phase were also more common in patients with paresis (P=0.00, OR: 4.88, 95%CI: 1.91-12.46), hemorrhagic lesions indicated by imaging (P=0.02, OR: 2.77, 95%CI: 1.08-7.10), supratentorial lesions, lesions in the frontal (P=0.01, OR: 3.81, 95%CI: 1.28-11.31) and parietal lobes (P=0.00, OR: 5.16, 95%CI: 2-13.29), thrombophilia and history of miscarriage (P=0.03, OR: 2.91, 95%CI: 1.07-7.91). No factor predicted acute or remote seizure in a multiple logistic regression analysis.
  
  
  CONCLUSIONS
  Our results demonstrate that seizure development in the acute phase is the most significant factor for development of remote seizure. Parenchymal lesions in the supratentorial area were also found to be associated with both acute and remote seizures. However, no factor was predictive of acute or remote seizures in a multivariate analysis.
authors.affiliation: Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Davoudi
authors.affiliation: Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Kiandokht
authors.initials: K
authors.lastname: Keyhanian
authors.affiliation: Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: mosaadatnia@yahoo.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Saadatnia
mesh_terms: D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000209:etiology* / Q000473:pathology; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000473:pathology; D013997:Time Factors
keywords: AED; Acute seizure; Antiepileptic drugs; CVST; Cerebral vein and dural sinus thrombosis; Predictor; Remote seizure