Occurrence and determinants of seizures and their impact on tuberculous meningitis : a prospective evaluation
© 2024. The Author(s) under exclusive licence to Belgian Neurological Society..
OBJECTIVE: To assess the incidence of seizures and the factors contributing to poor outcomes in patients with tuberculous meningitis (TBM).
METHODS: In this prospective observational study, 129 patients with TBM were enrolled at the Department of Neurology, King George's Medical University, Uttar Pradesh, India, from April 2021 to April 2023. Detailed clinical history, neurological examinations, baseline laboratory tests, contrast-enhanced Magnetic resonance imaging (MRI) and electroencephalography (EEG) were obtained for all patients. Patients received anti-tuberculous therapy and, if necessary, anti-epileptic treatment. Patients were followed for 6 months, with outcomes evaluated using the Modified Rankin Scale (MRS).
RESULTS: Of the 129 patients, 48 (37.2%) reported seizures. Advanced TBM stage (p = 0.040, OR = 2.50 95% CI:1.02-6.07), cortical involvement (p = .0.013, OR = 2.58 95% CI:1.20-5.51) and spike-wave discharges in the EEG (p = 0.001) were significantly associated with seizure occurrence. After multivariate analysis, only cortical involvement (p = 0.031, OR = 2.34, 95% CI:1.08-5.08) emerged as independent predictor of for seizures. Focal to bilateral seizures (p = 0.008, OR = 9.41, 95% CI: 1.76-74.04), status epilepticus (p = 0.002, OR = 8.00, 95% CI: 1.86-34.32), and rifampicin resistance (p = 0.022, OR = 9.25, 95% CI: 1.43-59.50) were significantly associated with poor outcomes at the 6-month mark.
CONCLUSION: Seizures were significantly associated with advanced stage of the disease, cortical involvement on neuro-imaging and epileptiform pattern on EEG. Additionally, focal to bilateral seizures and status epilepticus adversely affected the outcome.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Acta neurologica Belgica - (2024) vom: 02. Jan. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kirar, Roopesh Singh [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Revised 03.01.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1007/s13760-023-02444-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366583719 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366583719 | ||
| 003 | DE-627 | ||
| 005 | 20240108141827.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s13760-023-02444-2 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1248.xml |
| 035 | |a (DE-627)NLM366583719 | ||
| 035 | |a (NLM)38167743 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kirar, Roopesh Singh |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Occurrence and determinants of seizures and their impact on tuberculous meningitis |b a prospective evaluation |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 03.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s) under exclusive licence to Belgian Neurological Society. | ||
| 520 | |a OBJECTIVE: To assess the incidence of seizures and the factors contributing to poor outcomes in patients with tuberculous meningitis (TBM) | ||
| 520 | |a METHODS: In this prospective observational study, 129 patients with TBM were enrolled at the Department of Neurology, King George's Medical University, Uttar Pradesh, India, from April 2021 to April 2023. Detailed clinical history, neurological examinations, baseline laboratory tests, contrast-enhanced Magnetic resonance imaging (MRI) and electroencephalography (EEG) were obtained for all patients. Patients received anti-tuberculous therapy and, if necessary, anti-epileptic treatment. Patients were followed for 6 months, with outcomes evaluated using the Modified Rankin Scale (MRS) | ||
| 520 | |a RESULTS: Of the 129 patients, 48 (37.2%) reported seizures. Advanced TBM stage (p = 0.040, OR = 2.50 95% CI:1.02-6.07), cortical involvement (p = .0.013, OR = 2.58 95% CI:1.20-5.51) and spike-wave discharges in the EEG (p = 0.001) were significantly associated with seizure occurrence. After multivariate analysis, only cortical involvement (p = 0.031, OR = 2.34, 95% CI:1.08-5.08) emerged as independent predictor of for seizures. Focal to bilateral seizures (p = 0.008, OR = 9.41, 95% CI: 1.76-74.04), status epilepticus (p = 0.002, OR = 8.00, 95% CI: 1.86-34.32), and rifampicin resistance (p = 0.022, OR = 9.25, 95% CI: 1.43-59.50) were significantly associated with poor outcomes at the 6-month mark | ||
| 520 | |a CONCLUSION: Seizures were significantly associated with advanced stage of the disease, cortical involvement on neuro-imaging and epileptiform pattern on EEG. Additionally, focal to bilateral seizures and status epilepticus adversely affected the outcome | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Rifampicin resistance | |
| 650 | 4 | |a Seizures | |
| 650 | 4 | |a Status epilepticus | |
| 650 | 4 | |a Tuberculous meningitis | |
| 700 | 1 | |a Uniyal, Ravi |e verfasserin |4 aut | |
| 700 | 1 | |a Garg, Ravindra Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Verma, Rajesh |e verfasserin |4 aut | |
| 700 | 1 | |a Malhotra, Hardeep Singh |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Praveen Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Neeraj |e verfasserin |4 aut | |
| 700 | 1 | |a Pandey, Shweta |e verfasserin |4 aut | |
| 700 | 1 | |a Rizvi, Imran |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Amita |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Acta neurologica Belgica |d 1970 |g (2024) vom: 02. Jan. |w (DE-627)NLM000045705 |x 2240-2993 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:02 |g month:01 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s13760-023-02444-2 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 02 |c 01 | ||