Seizures in Cerebral Venous Sinus Thrombosis: Predictive Variables and Their Effect on Clinical Course

This study aimed to evaluate the effect of epileptic seizures on prognosis and the secondary factors accompanying this in patients with cerebral venous sinus thrombosis (CVST).This study was designed as a retrospective, cross-sectional study conducted between Jan 2007 and Dec 2017. Patients diagnosed with CVST aged 18 years or older who applied to the Neurology Clinic of Mersin University Faculty of Medicine Hospital were included in the study. Patients were divided into two groups: those with and without epileptic seizures, and both groups were evaluated with the modified Rankin Scale (mRS) at 1, 3, 6, and 12 months for 1 year. Epileptic seizures were observed in 35.2% of a total of 71 adults of the included patients in the study; 65.4% of these patients (n=17) were female, and the mean age was 36.8±15.8 years. When the prognoses of CVST patients with and without epileptic seizures were compared, a significant difference was found in terms of prognosis in the first month after discharge (p = 0.025). Severe disability (mRS ≥3) was observed more frequently in patients with epileptic seizures, and this difference was statistically significant (p = 0.022). Poor prognostic factors in CVST patients with epileptic seizures were failure to control seizures within the first 24 hours, presence of motor deficit, superior sagittal sinus involvement, frontal lobe involvement, and vasculitic etiology (Behçet's disease), while good prognostic factors were age <65 and absence of parenchymal involvement. Epileptic seizures do not significantly affect the prognosis in CVST patients after the first month after discharge. However, correct identification of risk factors, early diagnosis, and effective treatment can improve the functionality of patients in both the short and long term, thereby providing a better prognosis.