Epileptic seizures associated with progressive multifocal leukoencephalopathy in HIV-infected patients in Korea

Area of Science:

• Neurology
• Infectious Diseases
• Oncology

Background:

• Progressive multifocal leukoencephalopathy (PML) is a rare, demyelinating disease affecting the central nervous system.
• PML is often associated with opportunistic infections in immunocompromised individuals, particularly those with Human Immunodeficiency Virus (HIV).
• Seizures are a potential neurological complication of PML, but their incidence and risk factors in specific populations require further investigation.

Purpose of the Study:

• To determine the incidence of seizures in Korean patients with HIV-associated PML.
• To identify clinical and radiological risk factors associated with seizure development in this patient cohort.
• To understand the temporal relationship between PML diagnosis and seizure onset.

Main Methods:

• Retrospective analysis of 34 Korean patients diagnosed with HIV-associated PML.
• Data collection included patient demographics, clinical history, neurological examinations, and brain Magnetic Resonance Imaging (MRI) findings.
• Statistical analysis was performed to identify factors correlating with seizure occurrence.

Main Results:

• 14 out of 34 patients (41.2%) developed epileptic seizures during a median follow-up of 82 months.
• The median time from PML diagnosis to seizure onset was 44 months (range: 0-133 months).
• Seizure development was significantly associated with cognitive impairment and the presence of multiple or diffuse brain lesions on MRI.

Conclusions:

• HIV-infected patients with PML exhibit a substantial risk of developing seizures.
• Cognitive impairment and extensive/diffuse brain lesions on MRI are key indicators of increased seizure risk.
• This underscores the importance of monitoring for seizures throughout the course of PML in HIV-infected individuals, irrespective of disease stage.