Background Seizures are well described primary manifestation of Systemic Lupus Erythematosus (SLE). Lupus nephritis can further decrease seizure threshold due to hypertension, uremia and electrolyte abnormalities. In this study we investigated the risk of intractable epilepsy and status eplilepticus (general and partial) in SLE patients who have lupus nephritis.
Objectives To determine if lupus nephritis is an independent predictors of status epilepticus, grand mal status or epilepsia partialis continua in patients with SLE.
Methods We queried the Healthcare Cost and Utilization Project's (HCUP) Nationwide Inpatient Sample (NIS) between 2002 and 2011 and separated the hospitalizations due to or with SLE using ICD 9 diagnostic codes previously established by HCUP. Among this population, we examined the patients with lupus nephritis, and compared their risk of seizures using the logistic regression model. The model was controlled for variables which included age, sex, race, hypertension, ischemic stroke, intracranial bleed, chronic kidney disease, uremia, antiphospholipid antibodies, craniotomy, head trauma, hyponatremia, psychosis, lupus encephalitis, ischemic stroke, intracranial infections, brain neoplasms, use of immunosuppression, alcohol use, abnormal electroencephalogram (EEG) and use of antiepileptics. Using SAS 9.2, survey procedures were used to identify multivariate predictors of intractable epilepsy, grand mal status and epilepsia partialis continua.
Results A total of 1,631,680 who were hospitalized with SLE were available for analysis of which 907 (0.06%) patients had intractable epilepsy, 2092 (0.13%) patients had grand mal status and 146 (0.01%) patients had epilpesia partialis continua. The odds ratio (OR) of intractable epilepsy among SLE patients with lupus nephritis was 0.756 (Confidence Interval (CI) =0.411-1.387, p value=0.3659), OR for grand mal status was 1.022 (CI=0.735-1.423, p value=0.8955); whereas OR for epilepsia partialis continua was 3.000 (CI=1.208-7.453, p value=0.0179).
Conclusions Lupus nephritis is an independent predictor of epilepsia partialis continua in SLE patients; whereas it is not an independent predictor of intractable epilepsy or grand mal status.
Disclosure of Interest None declared