• Ming-Jung Chuang, Wen-Neng Chang, Hsueh-Wen Chang, Wei-Che Lin, Nai-Wen Tsai, Mei-Jen Hsieh, Hung-Chen Wang, and Cheng-Hsien Lu.
• Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
• J. Neurol. Neurosurg. Psychiatr.. 2010 Aug 1;81(8):913-7.

BackgroundSeizures are one of the most important neurological complications of bacterial brain abscesses. A better understanding of the risk factors of seizures following bacterial brain abscesses is needed to predict those who will require treatment.MethodsA total of 205 patients were enrolled in this 22-year retrospective study. Prognostic variables were analysed based on Cox's proportional hazards model after a minimum of 18 months of follow-up.ResultsSeizures occurred in 48 patients who had bacterial brain abscesses, including acute symptomatic seizures in 17% (35/205) and unprovoked seizures in 6.4% (13/205). Altogether, 27 patients had early seizures and 21 had late seizures. The overall mortality rate in the seizure patients was 23% (11/48) and seven patients progressed to epilepsy.ConclusionCox's proportional hazards model demonstrated that valvular heart diseases as the underlying diseases and the presence of a fronto-parietal distribution of bacterial brain abscess were independently predictive of seizures, and the presence of late seizures was predictive of developing epilepsy. Most first seizures occurred within 3 y after bacterial brain abscesses.

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