Document 0323
 DOCN  M9590323
 TI    Prospective analysis of HIV associated seizures.
 DT    9509
 AU    Dore G; Brew B; HIV Medicine Unit, St. Vincent's Hospital, Sydney.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:177 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291776
 AB    OBJECTIVE: A prospective case-control study was undertaken to examine
       the causative factors for HIV-related seizures. METHODS: Patients under
       either inpatient or outpatient care of the HIV-medicine unit who had a
       documented seizure were included. Investigations included initial
       neurological examination, serum electrolytes, cerebral C.T. scanning and
       where appropriate lumbar puncture and CSF studies Control patients were
       selected randomly from current HIV-unit inpatients. RESULTS: Forty three
       patients have had documented seizures during the study period. The
       median CD4 lymphocyte count was 8/ul and 80% had a prior AIDS defining
       illness. Generalised seizures were seen in 86%, focal with 2 degrees
       generalisation in 12% and focal only in 2%. Eighty three per cent of
       patients had no prior history of seizures, 10% had prior seizures during
       their HIV illness and 7% had prior seizures that predated their HIV
       illness. Causative factors included Cerebral Toxoplasmosis (20%),
       Cryptococcal Meningitis (7%), Progressive Multifocal Leukoencephalopathy
       (7%), CMV encephalitis (4%), and Cerebral Lymphoma (2%). The aetiology
       was considered to be unknown in 43%, however of these patients (n = 18),
       8 were receiving Foscarnet therapy at the time of the seizure, which was
       highly significant when compared to the control group (p < 0.001).
       CONCLUSION: Seizures in HIV infection, generally occur late in the
       illness. Causative factors include opportunistic infections involving
       the CNS, however many patients have no definite causative factor
       demonstrated. Foscarnet therapy appears to have contributed to seizure
       activity in a large proportion of patients where there was no other
       obvious cause demonstrated.
 DE    AIDS-Related Opportunistic Infections/COMPLICATIONS/DIAGNOSIS  Brain
       Neoplasms/COMPLICATIONS/DIAGNOSIS  Cytomegalovirus
       Infections/COMPLICATIONS/DIAGNOSIS  CD4 Lymphocyte Count  Encephalitis,
       Viral/COMPLICATIONS/DIAGNOSIS  Epilepsy, Generalized/ETIOLOGY  Epilepsy,
       Partial/ETIOLOGY  Human  HIV Infections/*COMPLICATIONS/DIAGNOSIS
       Leukoencephalopathy, Progressive Multifocal/COMPLICATIONS/  DIAGNOSIS
       Lymphoma, AIDS-Related/COMPLICATIONS/DIAGNOSIS  Meningitis,
       Cryptococcal/COMPLICATIONS/DIAGNOSIS  Seizures/*ETIOLOGY  Toxoplasmosis,
       Cerebral/COMPLICATIONS/DIAGNOSIS  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).