Advanced

Features associated with epilepsy in the antiphospholipid syndrome

Shoenfeld, Yehuda; Lev, Shaul; Blatt, Ilan; Blank, Miri; Font, Joseph; von Landenberg, Philipp; Lev, Nirit; Zaech, Joseph; Cervera, Ricard and Piette, Jean-Charles, et al. (2004) In Journal of Rheumatology 31(7). p.1344-1348
Abstract
OBJECTIVE: To assess the frequency of epilepsy in primary and secondary antiphospholipid syndrome (APS); to analyze the clinical and laboratory features characterizing those with epilepsy in a cohort of 538 patients with APS; and to find associated features that would suggest risk factors for epilepsy in APS. METHODS: We analyzed the clinical features of patients with APS who had epilepsy and compared them to the clinical features of non-epileptic APS patients. RESULTS: Of 538 APS patients, 46 (8.6%) had epilepsy. Epilepsy was more prevalent among APS secondary to systemic lupus erythematosus (SLE) compared to primary APS (13.7% vs 6%; p < 0.05). The patients with epilepsy had a higher prevalence of central nervous system (CNS)... (More)
OBJECTIVE: To assess the frequency of epilepsy in primary and secondary antiphospholipid syndrome (APS); to analyze the clinical and laboratory features characterizing those with epilepsy in a cohort of 538 patients with APS; and to find associated features that would suggest risk factors for epilepsy in APS. METHODS: We analyzed the clinical features of patients with APS who had epilepsy and compared them to the clinical features of non-epileptic APS patients. RESULTS: Of 538 APS patients, 46 (8.6%) had epilepsy. Epilepsy was more prevalent among APS secondary to systemic lupus erythematosus (SLE) compared to primary APS (13.7% vs 6%; p < 0.05). The patients with epilepsy had a higher prevalence of central nervous system (CNS) manifestations including focal ischemic events (strokes or transient ischemic events, 54.3% vs 24.6%; p < 0.0001) and amaurosis fugax (15.2% vs 4.9%; p < 0.05). APS patients with epilepsy had a higher frequency of valvular pathology (30.4% vs 14.6%; p < 0.01), thrombocytopenia (43.5% vs 25%; p < 0.05), and livedo reticularis (26.1% vs 11.5%; p < 0.01). The multivariate logistic regression analysis found CNS thromboembolic events as the most significant factor associated with epilepsy, with an odds ratio (OR) of 4.05 (95% confidence interval, CI: 2.05-8), followed by SLE (OR 1.4, 95% CI 1.2-4.7), and valvular vegetations (OR 2.87, 95% CI 1-8.27). CONCLUSION: Epilepsy is common in APS and most of the risk seems to be linked to vascular disease as manifested by extensive CNS involvement, valvulopathy, and livedo reticularis and to the presence of SLE. These factors, however, explain only part of the increased occurrence of epilepsy in APS and other causes such as direct immune interaction in the brain should be investigated. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Rheumatology
volume
31
issue
7
pages
1344 - 1348
publisher
J Rheumatol Publ Co
external identifiers
  • pmid:15229954
  • scopus:3042727917
ISSN
0315-162X
language
English
LU publication?
yes
id
ef7830a0-60c9-4bf0-bd15-5f7524c7573e (old id 1129306)
date added to LUP
2008-06-17 16:33:04
date last changed
2017-11-05 03:31:38
@article{ef7830a0-60c9-4bf0-bd15-5f7524c7573e,
  abstract     = {OBJECTIVE: To assess the frequency of epilepsy in primary and secondary antiphospholipid syndrome (APS); to analyze the clinical and laboratory features characterizing those with epilepsy in a cohort of 538 patients with APS; and to find associated features that would suggest risk factors for epilepsy in APS. METHODS: We analyzed the clinical features of patients with APS who had epilepsy and compared them to the clinical features of non-epileptic APS patients. RESULTS: Of 538 APS patients, 46 (8.6%) had epilepsy. Epilepsy was more prevalent among APS secondary to systemic lupus erythematosus (SLE) compared to primary APS (13.7% vs 6%; p &lt; 0.05). The patients with epilepsy had a higher prevalence of central nervous system (CNS) manifestations including focal ischemic events (strokes or transient ischemic events, 54.3% vs 24.6%; p &lt; 0.0001) and amaurosis fugax (15.2% vs 4.9%; p &lt; 0.05). APS patients with epilepsy had a higher frequency of valvular pathology (30.4% vs 14.6%; p &lt; 0.01), thrombocytopenia (43.5% vs 25%; p &lt; 0.05), and livedo reticularis (26.1% vs 11.5%; p &lt; 0.01). The multivariate logistic regression analysis found CNS thromboembolic events as the most significant factor associated with epilepsy, with an odds ratio (OR) of 4.05 (95% confidence interval, CI: 2.05-8), followed by SLE (OR 1.4, 95% CI 1.2-4.7), and valvular vegetations (OR 2.87, 95% CI 1-8.27). CONCLUSION: Epilepsy is common in APS and most of the risk seems to be linked to vascular disease as manifested by extensive CNS involvement, valvulopathy, and livedo reticularis and to the presence of SLE. These factors, however, explain only part of the increased occurrence of epilepsy in APS and other causes such as direct immune interaction in the brain should be investigated.},
  author       = {Shoenfeld, Yehuda and Lev, Shaul and Blatt, Ilan and Blank, Miri and Font, Joseph and von Landenberg, Philipp and Lev, Nirit and Zaech, Joseph and Cervera, Ricard and Piette, Jean-Charles and Khamashta, Munther A and Bertolaccini, Maria L and Hughes, Graham R V and Youinou, Pierre and Meroni, Pierre Luigi and Pengo, Vittorio and Delgado Alves, J and Tincani, Angela and Szegedi, Gyula and Lakos, Gabriella and Sturfelt, Gunnar and Jönsen, Andreas and Koike, Takao and Sanmarco, Marielle and Ruffatti, Amelia and Ulcova-Gallova, Zdenka and Praprotnik, Sonja and Rozman, Blaz and Lorber, Margalit and Chapman, Joab and van-Breda-Vriezman, Peter J.C. and Damoiseaux, Jan},
  issn         = {0315-162X},
  language     = {eng},
  number       = {7},
  pages        = {1344--1348},
  publisher    = {J Rheumatol Publ Co},
  series       = {Journal of Rheumatology},
  title        = {Features associated with epilepsy in the antiphospholipid syndrome},
  volume       = {31},
  year         = {2004},
}