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Neurology International
Volume 6
Issue 4
10.4081/ni.2014.5547
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Neurology International is published by MDPI from Volume 12 Issue 3 (2020). Previous articles were published by another publisher in Open Access under a CC-BY licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Article

Neuroimaging Abnormalities and Seizure Recurrence in a Prospective Cohort Study of Zambians with Human Immunodeficiency Virus and First Seizure

by
Michael J. Potchen
1,
Omar K. Siddiqi
2,3,
Melissa A. Elafros
4,
Igor J. Koralnik
3,
William H. Theodore
5,
Izukanji Sikazwe
6,
Lisa Kalungwana
7,
Chrstopher M. Bositis
8 and
Gretchen L. Birbeck
9,10,*
1
Neuroradiology Division, Department of Imaging Sciences, University of Rochester, NY, USA
2
Department of Internal Medicine, University of Zambia, Lusaka, Zambia
3
Division of NeuroVirology, Beth Israel Deaconess Medical Center, Boston, MA, USA
4
College of Human Medicine, Michigan State University, East Lansing, MI, USA
5
Clinical Epilepsy Section, United States National Institutes of Health, Bethesda, MD, USA
6
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
7
Department of Psychology, University of Zambia, Lusaka, Zambia
8
Greater Lawrence Family Health Center, Lawrence, MA, USA
9
Epilepsy Division, Department of Neurology, University of Rochester, NY, USA
10
Chikankata Epilepsy Care Team, Mazabuka, Zambia
*
Author to whom correspondence should be addressed.
Neurol. Int. 2014, 6(4), 5547; https://doi.org/10.4081/ni.2014.5547
Submission received: 13 July 2014 / Revised: 13 July 2014 / Accepted: 11 August 2014 / Published: 23 October 2014

Abstract

In HIV-positive individuals with first seizure, we describe neuroimaging findings, detail clinical and demographic risk factors for imaging abnormalities, and evaluate the relationship between imaging abnormalities and seizure recurrence to determine if imaging abnormalities predict recurrent seizures. Among 43 participants (mean 37.4 years, 56% were male), 16 (37%) were on antiretroviral drugs, 32 (79%) had advanced HIV disease, and (28) 66% had multiple seizures and/or status epilepticus at enrollment. Among those with cerebrospinal fluid studies, 14/31 (44%) had opportunistic infections (OIs). During follow-up, 9 (21%) died and 15 (35%) experienced recurrent seizures. Edema was associated with OIs (odds ratio: 8.79; confidence interval: 1.03-236) and subcortical atrophy with poorer scores on the International HIV Dementia Scale) (5.2 vs. 9.3; P=0.002). Imaging abnormalities were not associated with seizure recurrence or death (P>0.05). Seizure recurrence occurred in at least a third and over 20% died during follow-up. Imaging was not predictive of recurrent seizure or death, but imaging abnormalities may offer additional diagnostic insights in terms of OI risk and cognitive impairment.
Keywords: prognosis; seizure recurrence; opportunistic infection; computed tomography; cognitive impairment; CHASE prognosis; seizure recurrence; opportunistic infection; computed tomography; cognitive impairment; CHASE

Share and Cite

MDPI and ACS Style

Potchen, M.J.; Siddiqi, O.K.; Elafros, M.A.; Koralnik, I.J.; Theodore, W.H.; Sikazwe, I.; Kalungwana, L.; Bositis, C.M.; Birbeck, G.L. Neuroimaging Abnormalities and Seizure Recurrence in a Prospective Cohort Study of Zambians with Human Immunodeficiency Virus and First Seizure. Neurol. Int. 2014, 6, 5547. https://doi.org/10.4081/ni.2014.5547

AMA Style

Potchen MJ, Siddiqi OK, Elafros MA, Koralnik IJ, Theodore WH, Sikazwe I, Kalungwana L, Bositis CM, Birbeck GL. Neuroimaging Abnormalities and Seizure Recurrence in a Prospective Cohort Study of Zambians with Human Immunodeficiency Virus and First Seizure. Neurology International. 2014; 6(4):5547. https://doi.org/10.4081/ni.2014.5547

Chicago/Turabian Style

Potchen, Michael J., Omar K. Siddiqi, Melissa A. Elafros, Igor J. Koralnik, William H. Theodore, Izukanji Sikazwe, Lisa Kalungwana, Chrstopher M. Bositis, and Gretchen L. Birbeck. 2014. "Neuroimaging Abnormalities and Seizure Recurrence in a Prospective Cohort Study of Zambians with Human Immunodeficiency Virus and First Seizure" Neurology International 6, no. 4: 5547. https://doi.org/10.4081/ni.2014.5547

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