THE SPECTRUM OF EPILEPSY IN SICKLE-CELL-ANEMIA

In a study population of 152 patients seen at Thomas Jefferson Univers ity Hospital's sickle cell center between 1981 and 1992, 21 patients w ith seizures were identified. Clinical charts, electroencephalograms a nd neuroradiological studies were reviewed retrospectively. Seventeen patients with epilepsy were identified. Eleven had generalized tonic-c lonic, 2 had partial, and 4 had poorly characterized seizures. CT/MRI evaluation was focally abnormal in 6 patients, 4 of whom had cortical lesions. Atrophy was noted in 3 patients, while imaging studies were n ormal in 6 patients. The EEGs demonstrated focal epileptiform discharg es in 9 patients, generalized slowing in 5 patients, and was normal in 3 patients. Four patients had generalized seizures only with meperidi ne administration, all of whom had nonfocal EEG and radiological studi es. We concluded that (1) epilepsy is more common in sickle cell patie nts than in the general population; (2) the majority of our epileptic sickle cell patients have nonfocal CT or MRI studies but demonstrate f ocal EEG abnormalities; and (3) meperidine administration is associate d with generalized seizures in sickle cell patients.