Risk factors for early-onset seizures in patients with cerebral venous sinus thrombosis: A meta-analysis of observational studies

Abstract

Purpose: We conducted a meta-analysis to determine the predictors of early-onset seizure in patients with cerebral venous sinus thrombosis (CVST) and to provide a basis for further clinical trials of prophylactic use of antiepileptic drugs in patients with CVST.

Method: The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant observational studies that investigated risk factors for early-onset seizures after CVST were retrieved from Pubmed and Embase databases. Odds ratios (OR) for early-onset seizures were calculated from the pooled data using the random effects model.

Results: Six observational studies (combined n = 1244) were included in this meta-analysis. Coma [OR, 2.265; 95% confidence interval (CI) 1.251-4.100], mental status (OR, 3.450; 95% CI 1.150-10.356), motor symptoms (OR, 3.726; 95% CI 2.519-5.514), involvement of cortical veins (OR, 3.574; 95% CI 2.521-5.068), supratentorial lesion (OR, 5.041; 95% CI 3.622-7.015), frontal lobe (OR, 3.481; 95% CI 1.703-7.114), parietal lobe (OR, 3.638; 95% CI 1.911-6.925), hemorrhagic lesions (OR, 2.505; 95% CI 1.485-4.225), and pregnancy (OR, 2.054; 95% CI 1.043-4.048) showed a significant association with early-onset seizures.

Conclusion: Involvement of a numer of specific cortical regions in the post-CVST phase may induce early-onset seizures, especially in the setting of concomitant hemorrhagic infarct or cortical vein involvement.

Keywords: Cerebral venous sinus thrombosis; Early-onset seizures; Meta-analysis; Risk factors.