Predictors of seizures in patients with cerebral venous thrombosis in the Thai population: A retrospective study

Purpose: This study aimed to define independent factors associated with the onset of early seizure (ES) amongst patients with cerebral venous thrombosis (CVT). Methods: This retrospective cohort study recruited patients diagnosed with CVT and hospitalised between 2002 and 2020. Demographic, clinical, and seizure characteristics; neuroimaging findings; and clinical outcomes were compared between the seizure and non-seizure groups. Factors with p-values of <0.05 in univariate analysis were included in multivariate logistic regression analysis to determine independent predictors of ES. Results: Amongst 180 CVT patients, the incidence of ES was 38.3%. Most seizures presented as the initial symptom. Focal to bilateral tonic-clonic seizure was the most common seizure type (82.6%). Recurrent serial seizure and non-fatal status epilepticus accounted for 56.5% and 8.7% cases, respectively. Intracerebral haemorrhage (adjusted odds ratio [aOR]=6.57, 95% confidence interval [CI], 2.25-19.21, p = 0.001) and dependency status at admission (aOR=3.32, 95% CI, 1.08-10.18, p = 0.036) independently predicted ES, whereas isolated increased intracranial pressure (aOR=0.05, 95% CI, 0.01-0.24, p < 0.001), isolated headache (aOR=0.10, 95% CI, 0.02-0.45, p = 0.002), straight sinus thrombosis (aOR=0.03, 95% CI, 0.00-0.37, p = 0.007), and cavernous sinus thrombosis (aOR=0.50, 95% CI, 0.01-0.53, p = 0.012) showed protective effects. Conclusion: Intracerebral haemorrhage and dependency status at admission independently predicted seizures, whereas isolated increased intracranial pressure, isolated headache, straight sinus thrombosis, and cavernous sinus thrombosis showed preventive effects.