Seizures in patients with human immunodeficiency virus infection
Chadha DS., Handa A., Sharma SK., Varadarajulu P., Singh AP.
Objective : To study the significance of new onset seizure in patient with human immunodeficiency virus (HIV) infection. Methods : Patients infected with HIV with new onset seizure were enrolled in the study. Seizure type was classified. Adequate work up was done to search for a cause of their initial seizure. All patients were administered antiepileptic drugs in addition those detected to have treatable opportunistic infection were treated for the same. Results : A total of 455 patients of HIV infection were admitted to this centre during study period, of these twenty three patients had new onset seizures. Seizures were generalized tonic-clonic in fifteen patients (65.21%), partial motor in six patients (26.08%) and partial motor with secondary generalization in two patients (8.69%). Recurrence of seizures was observed in 69.56% patients. Identified causes included cerebral toxoplasmosis in seven patients (30.43%), cryptococcal meningitis in four (17.39%), tuberculoma in three (13.04%), AIDS dementia complex in one (4.34%) and progressive multifocal leucoencephalopathy in one (4.34%). In seven patients (30.43%) seizures were not associated with any identifiable cause. Phenytoin was used for control of seizures and no side effects to the drug were noted during the brief period of follow up. Conclusion : Majority of patients with HIV infection and new onset seizures have secondary brain lesion as the cause of seizure. High rate of seizure recurrence mandates therapy of solitary seizure in patients with HIV infection.