@article{5960711cbe2a477281cb70f669e07720,
title = "Seizures in adults with suspected central nervous system infection",
abstract = "Background: Seizures can be part of the clinical presentation of central nervous system (CNS) infections. We describe patients suspected of a neurological infection who present with a seizure and study diagnostic accuracy of clinical and laboratory features predictive of CNS infection in this population. Methods: We analyzed all consecutive patients presenting with a seizure from two prospective Dutch cohort studies, in which patients were included who underwent cerebrospinal fluid (CSF) examination because of the suspicion of a CNS infection. Results: Of 900 episodes of suspected CNS infection, 124 (14%) presented with a seizure. The median age in these 124 episodes was 60 years (IQR 45–71) and 53% of patients was female. CSF examination showed a leukocyte count ≥ 5/mm3 in 41% of episodes. A CNS infection was diagnosed in 27 of 124 episodes (22%), a CNS inflammatory disorder in 8 (6%) episodes, a systemic infection in 10 (8%), other neurological disease in 77 (62%) and in 2 (2%) episodes another systemic disease was diagnosed. Diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of CNS infection in this population was low. CSF leukocyte count was the best predictor for CNS infection in patients with suspected CNS infection presenting with a seizure (area under the curve 0.94, [95% CI 0.88 – 1.00]). Conclusions: Clinical and laboratory features fail to distinguish CNS infections from other causes of seizures in patients with a suspected CNS infection. CSF leukocyte count is the best predictor for the diagnosis of CNS infection in this population.",
keywords = "CNS infection, Cerebrospinal fluid, Diagnostic accuracy, Epilepsy",
author = "Olie, {Sabine E.} and {van Zeggeren}, {Ingeborg E.} and {ter Horst}, Liora and {I.-PACE Study Group} and J. Citroen and {van Geel}, {B. M.} and Heckenberg, {S. G. B.} and K. Jellema and Kester, {M. I.} and J. Killestein and Mook, {B. B.} and Titulaer, {M. J.} and {van Veen}, {K. E. B.} and Verschuur, {C. V. M.} and {van de Beek}, Diederik and Brouwer, {Matthijs C.}",
note = "Funding Information: No acknowledgements. CONSORTIUM NAME {\textquoteleft}I-PACE Study Group{\textquoteright} Collaborating author names (alphabetical order): J. Citroen3, B.M. van Geel4, S.G.B. Heckenberg5, K. Jellema6, M.I. Kester7, J. Killestein2, B.B. Mook8, M.J. Titulaer9, K.E.B. van Veen10, C.V.M. Verschuur11.2Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands.3OLVG, Department of Neurology, Jan Tooropstraat 9, Amsterdam, the Netherlands.4Noordwest Ziekenhuisgroep, Department of Neurology, Wendelaarstraat 58, Alkmaar, the Netherlands.5Spaarne Gasthuis, Department of Neurology, Boerhaavelaan 22, Haarlem, the Netherlands.6Haaglanden MC, Department of Neurology, Lijnbaan 32, Den Haag, the Netherlands.7Flevoziekenhuis, Department of Neurology, Hospitaalweg 1, Almere, the Netherlands.8HagaZiekenhuis, Department of Neurology, Els Borst-Eilersplein 275, Den Haag, the Netherlands.9Erasmus MC, Department of Neurology, Doctor Molewaterplein 40, Rotterdam, the Netherlands.10Alrijne Ziekenhuis, Department of Neurology, Simon Smitweg 1, Leiderdorp, the Netherlands.11Albert Schweitzer ziekenhuis, Department of Neurology, Albert Schweitzerplaats 25, Dordrecht, the Netherlands. Funding Information: This work was supported by the Netherlands Organization for Health Research and Development (ZonMw; NWO-Vidi Grant [grant number 917.17.308] and the European Research Council (ERC consolidator grant [grant number 101001237] to M.B.). Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = dec,
day = "1",
doi = "https://doi.org/10.1186/s12883-022-02927-4",
language = "English",
volume = "22",
pages = "426",
journal = "BMC Neurology",
issn = "1471-2377",
publisher = "BioMed Central",
number = "1",
}