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Research paper
Predictors and long-term outcome of seizures after bacterial brain abscess
  1. Ming-Jung Chuang1,
  2. Wen-Neng Chang2,
  3. Hsueh-Wen Chang3,
  4. Wei-Che Lin4,
  5. Nai-Wen Tsai2,
  6. Mei-Jen Hsieh2,
  7. Hung-Chen Wang1,
  8. Cheng-Hsien Lu2
  1. 1Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
  2. 2Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
  3. 3Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
  4. 4Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
  1. Correspondence to Cheng-Hsien Lu, Department of Neurology, Chang Gung Memorial Hospital, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan; chlu99{at}ms44.url.com.tw

Abstract

Background Seizures are one of the most important neurological complications of bacterial brain abscesses. A better understanding of the risk factors of seizures following bacterial brain abscesses is needed to predict those who will require treatment.

Methods A total of 205 patients were enrolled in this 22-year retrospective study. Prognostic variables were analysed based on Cox's proportional hazards model after a minimum of 18 months of follow-up.

Results Seizures occurred in 48 patients who had bacterial brain abscesses, including acute symptomatic seizures in 17% (35/205) and unprovoked seizures in 6.4% (13/205). Altogether, 27 patients had early seizures and 21 had late seizures. The overall mortality rate in the seizure patients was 23% (11/48) and seven patients progressed to epilepsy.

Conclusion Cox's proportional hazards model demonstrated that valvular heart diseases as the underlying diseases and the presence of a fronto-parietal distribution of bacterial brain abscess were independently predictive of seizures, and the presence of late seizures was predictive of developing epilepsy. Most first seizures occurred within 3 y after bacterial brain abscesses.

  • Outcome
  • risk factors
  • seizures
  • bacterial brain abscess
  • bacteriology
  • epilepsy
  • microbiology

https://doi.org/10.1136/jnnp.2009.195073

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    Footnotes

    • Competing interests None.

    • Ethics approval The study was approved by Chang Gung Memorial Hospital's Institutional Review Committee on Human Research.

    • Provenance and peer review Not commissioned; externally peer reviewed.