Sinüs ven trombozu ve epileptik nöbetler: uzun dönem takip sonuçları

Amaç: Serebral Venöz Sinüs Trombozunun (SVST) akut fazında hastaların yaklaşık %35-50'sinde epileptik nöbetler görülmektedir. Bu çalışmada, bir yıllık takip süresi boyunca hastaların demografik ve klinik özellikleri, nöbet sıklığı ve prognozunun araştırılması amaçlanmıştır. Gereç ve Yöntem: Retrospektif olarak yapılan bu çalışmada 1 Ocak 2018 ile 1 Ocak 2022 tarihleri arasında akut iskemik inme tanısı ile takip edilen hastaların dosyaları değerlendirildi. Demografik özellikler, nöbet öyküsü varlığı ve nöbet sıklığı, nörogörüntüleme bulguları, etkilenen serebral venöz sinüsler ve nöbet önleyici ilaç kullanımı kaydedildi. Bulgular: Akut inme geçiren toplam 701 hastanın tıbbi kayıtları incelenmiştir. 701 hastanın 32'sine (%4,56) SVST tanısı kondu; hastaların %37,5'inde erken başlangıçlı nöbetler görüldü. Nöbet geçiren hastaların %88,8'inde (n:8) monoterapi ile nöbet kontrolü sağlanmıştır. Nöbet geçiren hastalarda tutulan sinüsler; %50 (n=6) superior sagittal sinüs en sık tutulan sinüs olup, inferior sagittal sinüs ve sinüs rektus tutulumu izlenmemiştir. Sinüs tutulumu açısından nöbet geçiren ve geçirmeyen hastalar arasında istatistiksel olarak anlamlı bir fark yoktu. Beyin manyetik rezonans görüntülemede nöbet geçiren hastaların %66,7'sinde (n=8) venöz enfarkt saptanırken, nöbet geçirmeyen hastaların %35'inde saptanmıştır. Sonuç: Çalışmamız, nöbetlerin tipik olarak hastalığın erken dönemlerinde ortaya çıktığını, uzun vadede olumlu bir prognoza sahip olduğunu ve monoterapi ile yönetilebileceğini ortaya koymuştur.

Anahtar Kelimeler:

Epilepsi, serebral venöz sinüs trombozu, nöbet önleyici ilaçlar, prognoz

Sinus vein thrombosis and epileptic seizures: outcomes of long term follow-up

Purpose: In the acute phase of Cerebral Venous Sinus Thrombosis (CVST), approximately 35-50 % of patients diagnosed epileptic seizures. This study aimed to investigate the demographic and clinical characteristics, frequency of seizures, prognosis of patients during a one-year follow-up period. Materials and Methods: The files of patients who were followed up with the diagnosis of acute ischemic stroke between January 1, 2018 and January 1, 2022 were evaluated in this retrospective study. Demographic features, presence of seizure history and seizure frequency, neuroimaging findings, affected cerebral venous sinuses, and anti-seizure medication use were recorded. Results: A total of 701 patients with acute stroke had their medical records reviewed. Thirty-two of 701 patients (4.56 %) were diagnosed with CVST; 37.5 % of patients experienced early-onset seizures. Seizure control was achieved with monotherapy in 88.8 % (n:8) of patients with seizures. Involved sinuses in patients with seizures; 50 % (n=6) superior sagittal sinus was the most commonly involved sinus and inferior sagittal sinus and sinus rectus were not involved. In terms of sinus involvement, there was no statistically significant difference between patients with and without seizures. On cerebral magnetic resonance imaging, venous infarcts were detected in 66.7 % (n=8) of patients with seizures, compared to 35 % of patients without seizures. Conclusion: This retrospective study revealed that seizures typically occur early in the disease, have a favorable prognosis over the long term, and can be managed with monotherapy.

Keywords:

Epilepsy, Cerebral venous sinus thrombosis, Anti-seizure medication, prognosis,

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