New-onset seizures in adults with tuberculous meningitis during long-term follow-up: Characteristics, functional outcomes and risk factors.

OBJECTIVE

This study aimed to determine the characteristics and risk factors of adult new-onset seizure patients with tuberculous meningitis (TBM) during long-term follow-up.

METHODS

Patients with TBM who were seen between June 2012 and January 2018 were retrospectively reviewed and categorized into two groups based on the presence or absence of new-onset seizures. Seizure characteristics, functional outcomes and risk factors were assessed.

RESULTS

A total of 223 patients with TBM were enrolled, including 20.6% (46/223) with seizures. In all, 39.1% (18/46) of the patients with new-onset seizures and 14.1% (25/177) of the patients without seizures died (p < 0.001). Seizures were classified as single (n = 14/46, 30.4%), repetitive (n = 25/46, 54.3%), or status epilepticus (n = 7/46, 15.2%). We found that non-single seizures (repetitive seizures and status epilepticus) were associated with mortality (P = 0.002, P = 0.022), while single seizures were not (P = 0.834). The independent risk factors associated with non-single seizures were cortical involvement (p = 0.007) and epileptiform discharges (p = 0.001).

CONCLUSIONS

Non-single seizures were associated with poor functional outcomes and should be noted by the clinic. Cortical involvement and epileptiform discharges are independent risk factors for non-single seizures.