European Journal of Molecular & Clinical Medicine

Introduction: Cerebral venous thrombosis is mostly an uncommon but severe
thrombotic manifestation which has a high mortality rate, has the potential to end in
disability and the greater tendency of recurrence. There are some coagulation
abnormalities such as gain-of-function mutations in the genes that encodes factor V
(factor V Leiden) and prothrombin3 are presented with an increased risk of cerebral
vein thrombosis4-6 whereas there are no data currently reported on the role of
hyperhomocysteinemia as a risk factor for cerebral venous thrombosis. High plasma
levels of total homocysteine (tHcy) result from the connection between genetic and
acquired determinants. Cerebral venous thrombosis is one of the commonest causes of
stroke as far as Indian population is concerned. CVST usually predisposes in the state
of pregnancy and puerperium. The pathological hallmark that is reported in CVST is
haemorrhagic infarction. CVST predominantly occur in the young individuals and can
present with a broad spectrum of clinical manifestations which include headache,
altered sensorium, seizures, focal neurological deficits, papilloedema and cranial nerve
palsies. Headache is the most frequent and often the first reported clinical
manifestation. Homocysteine (Hcy) is a sulfhydryl amino acid compound that is
generated from protein breakdown and the essential amino acid methionine as it is
metabolized to cysteine. Hcy can be broken down in two pathways. When there is in
excess methionine, Hcy is directed to transulphuration pathway where it is irreversibly
conjugated to cysteine. Hcy can also be remethylated in a methionine conserving
pathway and this pathway requires folic acid and MTHFR.

Background and objective - Seizures are common disorders found all over the world and are encountered frequently during medical practice in variety of settings. Etiological spectrum of acute symptomatic seizures in developing countries is different from developed countries. So this study was done to know the various etiologies of new onset seizures in adults in this region.
Methods - Consecutive 100 Cases of new onset seizures from the hospital attached to Vinayaka Mission’s Medical College, Karaikal, were included in the study. The etiology was determined by neuro imaging and appropriate investigations including cerebrospinal fluid examination.
Results - Of 100 patients 89% were acute symptomatic seizures 40% of SE were caused by neuro infections. Neuroinfection was the leading cause of seizure, which accounted for 34%, followed by Cerebrovascular accidents (29%) and metabolic (9%). Neuro cysticercosis is most common cause in neuroinfection (35%), followed by meningitis (29%) and cerebral malaria (17%). 8% of seizures were because of CNS Tuberculosis. 55% of the CVA were due stroke and 34% due to CVT. 14% of  seizures were pregnancy related. In patients with cerebrovascular diseases, aged under 40 years, cerebral venous thrombosis accounted for79%.