New-onset seizures associated with HIV infection

Abstract

The authors studied new-onset seizures in 60 heterosexual black South African HIV-infected patients who had not used IV drugs. An intracranial space-occupying lesion was identified in 53% of patients, meningitis in 22%, and no additional cause in 25%. Of the patients with an identifiable cause, 64% had probable tuberculosis (tuberculoma or tuberculous meningitis). The majority of patients had late-stage HIV infection (CD4 counts <200/mm(3)).

The frequency and profile of neurology in black South African HIV infected (clade C) patients — A hospital-based prospective audit

“…We previously described our experience with NOS in HIV and noted that in 75% of such patients the cause for the NOS was either meningitis or a SOL. In 25% of patients no cause is found and we proposed that NOS is due to direct infection by HIV [21].…”

Emergency centre investigation of first-onset seizures in adults in the Western Cape, South Africa

“…Since HIVpositive patients presenting with seizures, have a high incidence of cryptococcal meningitis and TBM there should be a low threshold for LP provided that there are no contraindications. [13,14] EEG showing presence of focal seizures may assist with localising the site involved and predict seizure recurrence, as well as signalling subclinical status epilepticus. Normal EEG findings do not exclude the diagnosis of epilepsy.…”

“…[12] HIV/AIDS patients frequently present with seizures. [13,14] Physicians must adopt a low threshold for neuroimaging and an LP is indicated if judged to be a safe procedure. [9,13] SA has a high HIV infection rate (10.5%), [15] but there are little data on seizures in the SA HIV-positive population.…”

“…[9,13] SA has a high HIV infection rate (10.5%), [15] but there are little data on seizures in the SA HIV-positive population. [14,15] …”

Hepatitis C virus co-infection increases neurocognitive impairment severity and risk of death in treated HIV/AIDS

“…Severe immunosuppression in HIV-infected individuals was associated with an increased prevalence of seizure/epilepsy [33,34]. HIV mono-infected individuals with severe immunosuppression (CD4 + T cell levels b200 cells/mm 3 at the first neurologic diagnosis) exhibited higher prevalence of seizures compared with persons with less severe immunosuppression (p b 0.05, Fig.…”