RT Journal Article
SR Electronic
T1 Features associated with epilepsy in the antiphospholipid syndrome.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1344
OP 1348
VO 31
IS 7
A1 Yehuda Shoenfeld
A1 Shaul Lev
A1 Ilan Blatt
A1 Miri Blank
A1 Joseph Font
A1 Philipp von Landenberg
A1 Nirit Lev
A1 Joseph Zaech
A1 Ricard Cervera
A1 Jean-Charles Piette
A1 Munther A Khamashta
A1 Maria L Bertolaccini
A1 Graham R V Hughes
A1 Pierre Youinou
A1 Pierre Luigi Meroni
A1 Vittorio Pengo
A1 J Delgado Alves
A1 Angela Tincani
A1 Gyula Szegedi
A1 Gabriella Lakos
A1 Gunnar Sturfelt
A1 Andreas Jönsen
A1 Takao Koike
A1 Marielle Sanmarco
A1 Amelia Ruffatti
A1 Zdenka Ulcova-Gallova
A1 Sonja Praprotnik
A1 Blaz Rozman
A1 Margalit Lorber
A1 Joab Chapman
A1 Peter J C van-Breda-Vriezman
A1 Jan Damoiseaux
YR 2004
UL http://www.jrheum.org/content/31/7/1344.abstract
AB OBJECTIVE: To assess the frequency of epilepsy in primary and secondary antiphospholipid syndrome (APS); to analyze the clinical and laboratory features characterizing those with epilepsy in a cohort of 538 patients with APS; and to find associated features that would suggest risk factors for epilepsy in APS. METHODS: We analyzed the clinical features of patients with APS who had epilepsy and compared them to the clinical features of non-epileptic APS patients. RESULTS: Of 538 APS patients, 46 (8.6%) had epilepsy. Epilepsy was more prevalent among APS secondary to systemic lupus erythematosus (SLE) compared to primary APS (13.7% vs 6%; p < 0.05). The patients with epilepsy had a higher prevalence of central nervous system (CNS) manifestations including focal ischemic events (strokes or transient ischemic events, 54.3% vs 24.6%; p < 0.0001) and amaurosis fugax (15.2% vs 4.9%; p < 0.05). APS patients with epilepsy had a higher frequency of valvular pathology (30.4% vs 14.6%; p < 0.01), thrombocytopenia (43.5% vs 25%; p < 0.05), and livedo reticularis (26.1% vs 11.5%; p < 0.01). The multivariate logistic regression analysis found CNS thromboembolic events as the most significant factor associated with epilepsy, with an odds ratio (OR) of 4.05 (95% confidence interval, CI: 2.05-8), followed by SLE (OR 1.4, 95% CI 1.2-4.7), and valvular vegetations (OR 2.87, 95% CI 1-8.27). CONCLUSION: Epilepsy is common in APS and most of the risk seems to be linked to vascular disease as manifested by extensive CNS involvement, valvulopathy, and livedo reticularis and to the presence of SLE. These factors, however, explain only part of the increased occurrence of epilepsy in APS and other causes such as direct immune interaction in the brain should be investigated.