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New-onset seizures associated with HIV infection
1Neurology Unit, Department of Medicine, Chris Hani Baragwanath Hospital, and the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Neurology
|November 30, 2000
Summary
New-onset seizures in South African HIV patients were often caused by tuberculosis, particularly in those with advanced HIV infection. Tuberculosis, including tuberculoma and tuberculous meningitis, was the most frequent identifiable cause.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- New-onset seizures are a significant neurological complication in patients with Human Immunodeficiency Virus (HIV) infection.
- Identifying the etiology of seizures in HIV-infected individuals is crucial for appropriate management, especially in resource-limited settings.
Purpose of the Study:
- To investigate the causes of new-onset seizures in a cohort of HIV-infected patients in South Africa.
- To determine the prevalence of specific underlying conditions, with a focus on tuberculosis.
Main Methods:
- Retrospective analysis of 60 heterosexual, Black South African patients with HIV and new-onset seizures.
- Exclusion of patients with a history of intravenous drug use.
- Diagnostic workup included neuroimaging to identify intracranial space-occupying lesions and meningitis.
Main Results:
- An intracranial space-occupying lesion was identified in 53% of patients.
- Meningitis was diagnosed in 22% of cases.
- Tuberculosis (tuberculoma or tuberculous meningitis) was the most common identifiable cause, accounting for 64% of cases with a known etiology.
- The majority of patients presented with late-stage HIV infection (CD4 counts <200/mm(3)).
Conclusions:
- Tuberculosis is a leading cause of new-onset seizures in HIV-infected individuals in South Africa, particularly in those with advanced disease.
- Neuroimaging and etiological investigations are essential for diagnosing seizure causes in this population.
- The findings highlight the significant burden of opportunistic infections, specifically tuberculosis, presenting as neurological complications in advanced HIV.
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