Demographic, Clinical, and Paraclinical Factors Predicting Seizure Occurrence in Patients with Cerebral Venous Sinus Thrombosis (CVST)

Background: Cerebral Venous Sinus Thrombosis (CVST) is an uncommon cause of stroke characterized by heterogeneous clinical manifestations, making its diagnosis challenging. Seizure is one of the most frequent complications of CVST and may adversely affect neurological outcomes. Identifying predictors of seizure occurrence may facilitate early risk stratification and optimize patient management. This study aimed to evaluate the demographic, clinical, and paraclinical factors associated with seizure occurrence in patients with CVST.Methods: In this prospective cross-sectional study, ۱۶۱ patients diagnosed with CVST and admitted to Imam Reza Hospital between ۲۰۱۹ and ۲۰۲۲ were enrolled using a census sampling method. Demographic characteristics, clinical manifestations, risk factors, Glasgow Coma Scale (GCS) scores, neuroimaging findings, laboratory data, electroencephalography (EEG) results, treatment modalities, and seizure characteristics were collected and analyzed using SPSS software.Results: Among the ۱۶۱ patients, ۷۲ (۴۴.۷%) experienced seizures, while ۸۹ (۵۵.۳%) did not. No significant difference was observed in the mean age between the two groups (P = ۰.۳۲۶). However, seizures occurred significantly more frequently in women than in men (P = ۰.۰۱۲). Among patients with seizures, ۴۳.۲% had focal seizures, ۴۳.۲% had generalized seizures, and ۱۳.۵% experienced status epilepticus. Antiseizure medication use was significantly associated with a lower incidence of seizures (P < ۰.۰۰۱). A significant association was also found between headache and seizure frequency (P = ۰.۰۴), with headache prevalence decreasing as seizure frequency increased. No statistically significant associations were observed between seizure occurrence and laboratory findings, neuroimaging results, or EEG abnormalities.Conclusion: Female sex and certain clinical manifestations were associated with an increased risk of seizures in patients with CVST, whereas paraclinical findings showed limited predictive value. Antiseizure therapy was associated with a reduced incidence of seizures. Careful assessment of clinical characteristics, together with appropriate therapeutic management, may improve early identification of high-risk patients and enhance clinical outcomes.

کلیدواژه ها:

Cerebral venous sinus thrombosis ، Seizure ، Risk factors ، Prognosis ، Electroencephalography (EEG) ، Neurological outcomes