Introduction: Some patients with epilepsy identify weather as a typical seizure trigger. However, it is yet to be confirmed. Thus, we aimed to evaluate possible relationships between daily meteorological conditions and the daily incidence of seizures. Methods: This was a retrospective single center study that included adult patients who were admitted to the emergency room of a tertiary hospital in Lisbon, with a seizure, between January and December 2015. The influence of temperature, atmospheric pressure, relative humidity, wind, precipitation, sunlight duration, and the seasons on seizure frequency was evaluated. Results: Three hundred seven seizure episodes were included (from 286 patients) in a total of 365 days, 117 (38.1%) first unprovoked seizures and 190 (61.9%) with previous seizure episodes. There were 82 days with higher incidence of seizures (≥2) and 171 days without seizures. We found a statistical significant relation between lower ambient temperatures, higher atmospheric pressure, and higher maximum humidity with days with two or more seizures. We also found a statistically significant higher incidence of seizures in the winter days (p-value: 0.001) and in days with lower daylight duration (10.8 vs. 12.7 h; p-value: 0.0001). With the exception of humidity, these findings remained true when analyzing the subgroup of patients with previous seizures, but there was no significant difference in the subgroup of first unprovoked seizures. Conclusions: Our results support the possible influence of the weather on seizure frequency in the overall admissions of the emergency department of a tertiary hospital. In particular, these findings suggest that winter conditions, such as, lower ambient temperatures, higher atmospheric pressure, higher humidity, and reduced sunlight exposure, may have impact in the occurrence of higher incidence of seizures in patients with epilepsy.

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Background: Acute vertigo (AV) is often a challenging condition. Because of its multiple causes, patients are frequently observed by neurologists and physicians from other areas of specialites, particularly Ear, Nose, and Throat (ENT). We aimed to assess the diagnostic accuracy of AV in patients observed by Neurology and other medical specialties. Materials and Methods: Retrospective cross-sectional study with the selection of all patients with AV observed by Neurology at the Emergency Department (ED) of a tertiary center in 2019, regarding demographic data, imaging studies, diagnosis by Neurology and ENT at the ED, and diagnosis after ED discharge by different medical specialties. Results: In all, 54 patients were selected, 28 (52%) of them were women. The mean age was 59.96±14.88 years; 48% had a history of AV and 89% underwent imaging studies (computed tomography scan and/or magnetic resonance imaging scan). The most frequent diagnosis established by Neurology was benign paroxysmal positional vertigo, followed by vestibular neuronitis; 28 patients were also observed by ENT with an overall concordance rate of diagnosis of 39%. After ED discharge, most patients were observed at the Balance Disorders Outpatient Clinic. Diagnosis by Neurology at the ED was not significantly different from observation by other medical specialties after ED discharge regarding the distinction between peripheral and central causes of AV (κ=0.840, 95% confidence interval: 0.740 to 0.941, P<0.005). Conclusions: Neurologists can effectively differentiate central and peripheral causes of AV at the ED. Patients with AV should be primarily evaluated by Neurology at the ED, avoiding redundant observations and allowing faster patient management.