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Factors at Diagnosis Predict Subsequent Occurrence of Seizures in SLE

Saturday, November 05, 2005

Factors at Diagnosis Predict Subsequent Occurrence of Seizures in SLE

Neurology 2005; 64:2102-2107 (June 2005)

Jamal Mikdashi, MD, MPH, Allan Krumholz, MD and Barry Handwerger, MD

This study followed 195 lupus patients for nine months and kept track of incidences and manifestations of neuropsychiatric SLE (NP-SLE) and seizures. Isolated seizures were found to be common (28 patients), while recurrent seizures, or epilepsy, although less frequent, did occur (12 of the 28). Predictors of seizures included disease activity (in particular, psychosis), moderate-to-high levels of anticardiolipin and anti-Sm antibodies, and damage accrual. Predictors of epilepsy were higher disease activity at baseline (when the study began), concurrent NP-SLE manifestations, prior strokes, and male gender.

The researchers conclusion is that the risk of seizure and epilepsy in lupus is increased in those individuals with higher disease activity at baseline, prior neuropsychiatric lupus disease, and positive tests for both anticardiolipin and anti-Sm antibodies. The ability to better predict seizures in individuals with NP-SLE may be useful in determining caregiving needs and the ability to perform activities of daily living, which are determinants of disability status.

Unlike other studies that have examined seizure risk factors after the fact, the goal of this study was to look for factors at the time of SLE diagnosis. These factors may help in understanding the pathogenesis of provoked seizures in SLE. It is believed that seizure occurrence is primarily related to increased disease activity, and that epilepsy may often be related to prior damage such as stroke. This information is vital for physicians in determining how best to treat lupus patients at higher risk for neurological manifestations like seizures.

To read the complete abstract go to:

http://www.neurology.org/cgi/content/abstract/64/12/2102

Blogged on 5:12 PM

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