Metabolic abnormalities and new-onset seizures in human immunodeficiency virus-seropositive patients.

Seizures are a recognized complication of human immunodeficiency virus (HIV)-type-1 infection. CNS disease processes in these patients include encephalitis, focal brain lesions, and meningitis. Metabolic causes of seizures have received little attention. In a retrospective study, we selected 68 HIV-seropositive patients with new-onset seizures and information available for specified metabolic factors on the day of the first seizure. We sought an association of metabolic abnormalities with convulsive status epilepticus (CSE), which was the initial seizure in 12 patients, predominantly intravenous (i.v.) drug users. HIV-seropositive patients with new-onset seizures and hypomagnesemia or renal failure appeared to be at increased risk for CSE. All HIV-seropositive patients with new-onset seizures should undergo metabolic screening including renal function and serum magnesium levels.