Epilepsia Open. 2023 Jul 9. doi: 10.1002/epi4.12787. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to investigate the proportion of patent foramen ovale (PFO) in people with epilepsy (PWE) compared to controls without epilepsy, and to assess whether PWEs with and without PFO exhibit distinctive clinical features.
METHODS: This is a case-control study conducted in a hospital. Contrast transthoracic echocardiography with a venous microbubble bolus and provocative maneuvers (Valsalva and coughing) were used to identify PFO and its right-to-left shunt (RLS) among 741 PWEs and 800 controls without epilepsy. The risk of having PFO in PWEs was explored using multiple matching methods and logistic regression with adjusted congenital factors that may affect the occurrence of PFO.
RESULTS: The proportion of PFO in PWEs and controls were 39.00% and 24.25%, respectively. After 1:1 propensity score matching, the risk of suffering PFO in PWEs was 1.71 times (OR, 1.71; 95%CI, 1.24 – 2.36) higher than that in controls. PWEs also had a higher risk of having a high RLS grade (βepilepsy = 0.390, p < .001). Among clinical characteristics of PWEs, migraine and drug-resistant epilepsy showed significantly different distributions between those without RLS and those with RLS grade I to III. PWEs with PFO had higher risk of suffering from migraine and drug-resistant epilepsy (OR in migraine, 2.54, 95%CI, 1.65 – 3.95; OR in drug-resistant epilepsy, 1.47, 95%CI, 1.06 – 2.03).
SIGNIFICANCE: The proportionof PFO was found to be higher in PWE than in controls without epilepsy, especially in patients with drug-resistant epilepsy, suggesting potential relationship between the two disorders. Large multicentric study will be needed to confirm this finding.
PMID:37422851 | DOI:10.1002/epi4.12787
