Abstract Details

Title Clinical and EEG Characteristics of Seizure Disorders in Neurosyphilis

Topic Epilepsy

Presentation(s) P07 - (-)

Poster/Presentation
Number 174

Objective

Background BACKGROUND: Syphilis has increased significantly over the last decade. Secondary and tertiary neurosyphilis result in meningovascular and parenchymal inflammation and stroke. This can potentially increase the risk of seizures. There is insufficient clinical data detailing seizure characteristics in neurosyphilis patients. Our study evaluated the seizure characteristics and EEG findings in a cohort of neurosyphilis patients at an inner city academic hospital.

Design/Methods DESIGN/METHODS: Retrospective chart review at an inner city, tertiary care hospital was conducted. After IRB approval, all inpatient and outpatient medical records from 01/01/2001 to 12/31/2011 with a diagnosis of neurosyphilis were identified. Neurosyphilis was diagnosed with either a positive CSF-Venereal Disease Research Laboratory (VDRL) test in a syphilis patient or by elevated protein or WBC in CSF of a syphilis patient with CSF-VDRL negative test. Charts of patients presenting with seizures or epilepsy were then reviewed. In these patients the seizure type and EEG findings were analyzed. Descriptive statistical tools are used to describe the data.

Results RESULTS: A total of 178 patients with confirmed or presumptive neurosyphilis were identified. Twenty two (12.4%) presented with a seizure. Mean age was 53. 6 years, 6 were female and 7 had concomitant HIV. Clinically, seizure type could reliably be determined in 17 patients: 6 had generalized tonic-clonic seizure, 4 had secondary generalization, 5 had complex partial and 2 had simple partial seizures. The interictal EEG in 21 of these patients showed: 9 having lateralized spike activity; 8 having generalized diffuse slowing; 2 patients showed PLEDs and 1 was normal.

Conclusions CONCLUSIONS: Neurosyphilis significantly increased the risk of seizures in our study group. Clinically focal seizures with secondary generalization were most common. Over fifty percent of patients had a focal EEG supporting the clinical seizure type.

Authors/Disclosures
Vineet Punia, MD (Cleveland Clinic) PRESENTER	Dr. Punia has nothing to disclose.
David A. Marks, MD	Dr. Marks has nothing to disclose.
Robert J. Fox, MD, FAAN (Cleveland Clinic)	Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AB Science. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Immunic. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siemens. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria Biologica. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for InnoCare Pharma. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AB Science. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. The institution of Dr. Fox has received research support from National Institutes of Health. The institution of Dr. Fox has received research support from National MS Society. Dr. Fox has received publishing royalties from a publication relating to health care.

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