Late seizures and morbidity after subdural empyema

Area of Science:

• Neurology
• Neurosurgery
• Infectious Diseases

Background:

• Subdural empyema is a serious intracranial infection with significant morbidity and mortality.
• Understanding the long-term neurological sequelae, particularly late seizures, is crucial for patient management.

Purpose of the Study:

• To assess the incidence of late seizures and neurological morbidity in patients with subdural empyema.
• To identify factors influencing the occurrence of early and late seizures and overall mortality.

Main Methods:

• A survey of 89 patients diagnosed with subdural empyema.
• Analysis of patient data including demographics, clinical presentation, treatment, and outcomes.
• Follow-up review of survivors to assess neurological deficits and seizure activity.

Main Results:

• Mortality rate was improved by craniotomy.
• 42% of patients without early seizures developed late seizures, typically within 16 months.
• Early seizures were associated with paranasal sepsis but not with late seizures.

Conclusions:

• Late seizures are a significant concern in subdural empyema survivors, particularly in those without preceding early seizures.
• While early seizures may correlate with mortality, they do not predict the occurrence of late seizures.
• Neurological recovery was not linked to surgical approach, but craniotomy improved survival rates.