Giant cell arteritis (GCA) as a risk factor for seizures: a cohort study

Area of Science:

• Neurology
• Rheumatology
• Epidemiology

Background:

• Giant Cell Arteritis (GCA) is a systemic vasculitis primarily affecting large arteries.
• The neurological complications of GCA, including seizures, require further investigation.
• Understanding GCA's impact on seizure risk is crucial for patient management.

Purpose of the Study:

• To evaluate the incidence of seizures in a large cohort of Giant Cell Arteritis patients.
• To compare seizure risk between GCA patients and a matched control group.
• To determine if the association between GCA and seizures is independent of stroke risk.

Main Methods:

• A retrospective cohort study included 8,103 GCA patients and 32,412 matched controls from Israel (2002-2017).
• Controls were matched for age, sex, socioeconomic status, country of birth, diabetes, and hypertension.
• Cox regression models were used to calculate hazard ratios for seizures.

Main Results:

• The incidence of seizures was 15.92 per 10,000 person-years in GCA patients versus 9.62 in controls.
• GCA was significantly associated with an increased risk of seizures (adjusted HR=1.67, 95% CI [1.3-2.14]).
• This association remained significant after adjusting for stroke (HR=1.55, 95% CI [1.16-2.07]).

Conclusions:

• Individuals with Giant Cell Arteritis have a substantially higher risk of developing seizures.
• The pro-inflammatory state in GCA may lower the neuronal threshold, contributing to seizures.
• This increased seizure risk is not solely attributable to stroke in GCA patients.