| Objective:To investigate the risk factors of secondary epileptic seizures in patients with cerebral venous sinus thrombosis(CVST)in acute phase and its influence on prognosis.The recovery of patients with CVST secondary epileptic seizures who took antiepileptic drugs(AEDs)was followed up to observe the prognosis of epileptic seizures in these patients.Methods:A retrospective study was conducted on 114 cases of CVST diagnosed in the Affiliated Hospital of Qingdao University from July 2000 to July 2017.The data of 114 cases were read in detail and completely.Some of them were re-hospitalized for the same patient because of incomplete imaging data.A total of 16 cases were excluded.Finally,the patients who had been diagnosed by imaging Magnetic resonance venography ? Computed tomography angiography or Digital subtraction angiography were selected.A total of 98 patients were recorded.By consulting the medical records of all 98 patients,the demographic information,clinical symptoms,signs,imaging findings,cerebrospinal liquefaction test results,epileptic seizures,AEDs treatment,overall prognosis and control of epilepsy were collected for statistical analysis.According to whether or not epileptic seizures occur in the acute phase of CVST,98 patients were divided into secondary epileptic seizures group(group A)34 cases and non-secondary epileptic seizures group(group B)64 cases.The risk factors of group A and group B were analyzed by logistic regression method,and the results of related factors and independent risk factors were obtained.The recovery of antiepileptic drugs(AEDs)was followed up.Thirty-four patients in the secondary epileptic seizure group were followed up by telephone,29 cases were followed up,5 cases were lost and 29 cases were followed up.The recovery of epileptic seizure,the overall prognosis,the name of AEDs,the time of taking medicine and the effect on the prognosis of the disease were counted.Thirty-four patients in the secondary epileptic seizure group were followed up with a standard follow-up questionnaire.The deadline for follow-up was one year after discharge.IV Follow-up methods include outpatient consultation and telephone follow-up.The outpatientre-visited patients consulted the outpatient electronic medical record system for statistics,and telephone follow-up was conducted for patients who did not have outpatient re-visits.The recovery of epileptic seizures,the overall prognosis,the name of AEDs,the time of taking AEDs and the effect on the prognosis of the disease were analyzed..Results:Among 98 CVST patients,39 were male,59 were female,34 were secondary epilepsy in acute stage,64 were non-secondary epilepsy,and the incidence of secondary epilepsy in acute stage was 34.7%.Univariate and multivariate analysis and comparison were made between the two groups.The univariate analysis showed that there were significant differences in the upper sagittal sinus involvement and transverse sinus involvement between group A and group B(t=5.987,8.734,P < 0.05),suggesting that the upper sagittal sinus involvement and transverse sinus involvement were important factors for secondary epilepsy in acute CVST patients.There was no significant difference between the two groups(t=3.567,P=0.059),but considering that the P value is close to 0.05,we can increase the sample size in future research to carry out statistical analysis in this regard,in order to further clarify whether it is a related factor.Pregnant women or puerperium(t = 0.152,P = 0.697)did not increase the risk of secondary epilepsy in patients with CVST in acute phase.For cerebral hemorrhage(t=2.918,P=0.088)and disturbance of consciousness(t=1.907,P=0.385),the results showed that there was no significant difference between the two,suggesting that they did not increase the risk of secondary epilepsy in patients with CVST in acute phase.Multivariate logistic regression analysis showed that superior sagittal sinus involvement was an independent risk factor for secondary epileptic seizures in patients with CVST in acute phase(OR=2.732,95% CI=1.075-6.945,P<0.05).Among thirty-four patients with secondary epileptic seizures in group A,five cases were lost and twenty-nine cases were successfully followed up.Four of them were followed up in outpatient clinic.The diagnosis was made by the professional deputy chief physician or chief physician of neurology.Twenty-five patients without outpatient consultation were followed up by telephone.The telephone follow-up was completed by the professionalneurologist.Among the twenty-nine patients followed up: two died in hospital,twenty-three(79.3%)had no epileptic seizures after discharge(nine patients continued to take AEDs after discharge,one patient stopped taking AEDs for two weeks,four patients stopped taking AEDs for three months and four patients stopped taking AEDs for half a year;Fourteen patients did not take AEDs after discharge);Two patients(6.9%)had one episode at two weeks and one month after discharge,and did not relapse after taking AEDs.Two patients(6.9%)still had episodes at one year after discharge.Follow-up results showed that the prognosis of secondary epileptic seizures in acute phase was better in CVST patients.93.1% of the patients did not have epileptic seizures after1 year of discharge.Most patients did not need to take AEDs for a long time.Only 6.9% of the patients still had epileptic seizures despite taking AEDs.Conclusion:1.Superior sagittal sinus involvement is an independent risk factor for secondary epileptic seizures in patients with CVST in acute phase.2.Superior sagittal sinus involvement and transverse sinus involvement are important influencing factors of secondary epileptic seizures in acute CVST patients.3.The prognosis of secondary epileptic seizures in acute phase of CVST patients is good,and most patients do not need to take AEDs for a long time. |
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