Abstracts

Rationale: Background. Seizures are a serious complication of central nervous system (CNS) infections. However, the role of prolonged, continuous electroencephalographic recording (cEEG) in patients with primary CNS infection has not been properly assessed. Objective: To determine the prevalence, predictors, and clinical significance of electrographic seizures and other cEEG findings in patients suffering from CNS infection.Methods: Methods. We retrospectively reviewed all patients admitted to Columbia University Medical Center from January 1st 1996 to February 28th 2007 with the diagnosis of primary CNS infection and in whom cEEG was performed. Patients with CNS infection following neurosurgery were excluded. Results: Results. Forty-two patients with primary CNS infection were included in our study. Mean age was 39 years. There were 21 men. Electrographic seizures were recorded in 14 (33 %) patients, and periodic epileptiform discharges (PEDS) in 13. 11 patiwnts with electrographic seizures had PEDS. Of the 14 with seizures recorded, 5 had activity noted clinically. After correction for age and level of consciousness on admission, two independent predictors of electrographic seizures were identified: PEDS (Hazard ratio (HR)= 21, p=0.001) and a viral etiology (HR= 13, p=0.023). No significant clinical predictors including clinical seizures during the course of the disease of seizures were identified. Electrographic seizures (HR=7;p=0.019) and PEDS (HR=6;p=0.017) were independent predictors of poor outcome at discharge (Glasgow Outcome Scale 3-5), but clinical seizures were not. Conclusions: Conclusion. A viral etiology and PEDS were independent predictors of electrographic seizures. Electrographic seizures and PEDS were independent predictors of poor outcome. Additional studies are needed to determine if prevention or treatment of these electrographic findings can improve outcome.