Incidence and association of seizures in stroke patients following endovascular treatment: A systematic review and meta‐analysis

Liu, Fangzhou; Deng, Chao; Fu, Yaoqi; Wang, Haijiao; Liu, Ling

doi:10.1111/ene.15564

Cited by 5 publications

(3 citation statements)

References 44 publications

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“…The incidence of early ES was 2.7%, while late ES occurred at 2.4%. This was consistent with the current literature that reports early ES rates after acute ischemic stroke ranging from 1% to 13.6% [8,[32][33][34][35], and late ES from 2% to 9% [8,32,33,35]. Additionally, we also observed a similar increase in late ES risk after the occurrence of early ES [23,36,37].…”

Section: Discussionsupporting

confidence: 93%

The Association of Epileptic Seizures after Acute Ischemic Stroke with Cerebral Cortical Involvement and Electroencephalographic Changes

Šmigelskytė,

Rimkuvienė,

Žukaitė

et al. 2024

Medicina

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Background and objectives: while acute ischemic stroke is the leading cause of epilepsy in the elderly population, data about its risk factors have been conflicting. Therefore, the aim of our study is to determine the association of early and late epileptic seizures after acute ischemic stroke with cerebral cortical involvement and electroencephalographic changes. Materials and methods: a prospective cohort study in the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics Department of Neurology was conducted and enrolled 376 acute ischemic stroke patients. Data about the demographical, clinical, radiological, and encephalographic changes was gathered. Patients were followed for 1 year after stroke and assessed for late ES. Results: the incidence of ES was 4.5%, the incidence of early ES was 2.7% and the incidence of late ES was 2.4%. The occurrence of early ES increased the probability of developing late ES. There was no association between acute cerebral cortical damage and the occurrence of ES, including both early and late ES. However, interictal epileptiform discharges were associated with the occurrence of ES, including both early and late ES.

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Section: Discussionsupporting

confidence: 93%

The Association of Epileptic Seizures after Acute Ischemic Stroke with Cerebral Cortical Involvement and Electroencephalographic Changes

Šmigelskytė,

Rimkuvienė,

Žukaitė

et al. 2024

Medicina

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“…Devastation of a stroke extends beyond the initial event, as survivors frequently encounter post-stroke complications that bear significant impact on their life quality. The advent of seizures following a stroke is a critical complication that can exacerbate the disease burden [3][4] .…”

Section: Introductionmentioning

confidence: 99%

“…Despite the fact that endovascular treatments have significantly improved stroke outcomes, the incidence of seizures following such procedures remains a major cause for concern 4,12 .…”

Section: Introductionmentioning

confidence: 99%

Incidence and Association of Seizures in Stroke Patients Undergoing Endovascular Therapies

Khan Alizai,

Tasleem,

Hashim

et al. 2023

PJMHS

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Background: Endovascular therapies have revolutionized the treatment of stroke, but post-stroke seizures continued as significant complication that impacted morbidity. Objectives: We examined the incidence and association of seizures in stroke patients undergoing endovascular therapy (EVT). Methods: Investigation included 384 hospitalized patients with acute ischemic or hemorrhagic stroke undergoing EVT. To distinguish and investigate the stroke, and to identify subtypes of stroke using the TOAST classification, the incidence of seizures was determined in stroke patients following EVT through brain imaging. Results: We analyzed the demographic and clinical characteristics of 384 stroke patients who underwent EVT and had seizures. Seizures were found to occur in 6.51% of EVT patients (p>0.05). Occurrence of seizures was non-substantially affected by comorbidities like hypertension, cardiac maladies and diabetes. Majority of stroke patients (82.81%) suffered from ischemic strokes, while only 17.18% had hemorrhagic strokes. Large artery atherosclerosis was the most prevalent subtype of stroke associated with seizures following EVT. The severity of the stroke and existing of cortical involvement were not significantly associated with seizures (p<0.05), whereas lower age and early seizures after EVT were associated with a marginally increased risk of experiencing seizures. Overall, study indicated that incidence of seizures following EVT was relatively low and influenced by particular factors. Practical implication: This study emphasized the need for personalized patient care strategies, including vigilant surveillance for seizures and preventative interventions, to enhance the outcomes of stroke patients undergoing endovascular therapy. Conclusion: Seizures are a significant complication of EVT for stroke patients. Stroke severity and etiology may influence seizure risk, highlighting the significance of vigilant monitoring and proactive management to reduce the incidence of seizures in this patient population. Keywords: Endovascular treatment; Epidemiology; Epilepsy; Hemorrhage; Seizures; Thrombectomy.

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Frequency and predictors of poststroke epilepsy after mechanical thrombectomy for large vessel occlusion stroke: results from a multicenter cohort study

Gruber,

Gattringer,

Mayr

et al. 2023

J Neurol

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Background Poststroke epilepsy (PSE) represents an important complication of stroke. Data regarding the frequency and predictors of PSE in patients with large-vessel occlusion stroke receiving mechanical thrombectomy (MT) are scarce. Furthermore, information on acute and preexisting lesion characteristics on brain MRI has not yet been systematically considered in risk prediction of PSE. This study thus aims to assess PSE risk after acute ischemic stroke treated with MT, based on clinical and MRI features. Methods In this multicenter study from two tertiary stroke centers, we included consecutive acute ischemic stroke patients who had received MT for acute intracranial large vessel occlusion (LVO) between 2011 and 2017, in whom post-interventional brain MRI and long term-follow-up data were available. Infarct size, affected cerebrovascular territory, hemorrhagic complications and chronic cerebrovascular disease features were assessed on MRI (blinded to clinical information). The primary outcome was the occurrence of PSE (> 7 days after stroke onset) assessed by systematic follow-up via phone interview or electronic records. Results Our final study cohort comprised 348 thrombectomy patients (median age: 67 years, 45% women) with a median long-term follow-up of 78 months (range 0–125). 32 patients (9%) developed PSE after a median of 477 days (range 9–2577 days). In univariable analyses, larger postinterventional infarct size, infarct location in the parietal, frontal or temporal lobes and cerebral microbleeds were associated with PSE. Multivariable Cox regression analysis confirmed larger infarct size (HR 3.49; 95% CI 1.67–7.30) and presence of cerebral microbleeds (HR 2.56; 95% CI 1.18–5.56) as independent predictors of PSE. Conclusion In our study, patients with large vessel occlusion stroke receiving MT had a 9% prevalence of PSE over a median follow-up period of 6.5 years. Besides larger infarct size, presence of cerebral microbleeds on brain MRI predicted PSE occurrence.

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Incidence and association of seizures in stroke patients following endovascular treatment: A systematic review and meta‐analysis

Cited by 5 publications

References 44 publications

The Association of Epileptic Seizures after Acute Ischemic Stroke with Cerebral Cortical Involvement and Electroencephalographic Changes

The Association of Epileptic Seizures after Acute Ischemic Stroke with Cerebral Cortical Involvement and Electroencephalographic Changes

Incidence and Association of Seizures in Stroke Patients Undergoing Endovascular Therapies

Frequency and predictors of poststroke epilepsy after mechanical thrombectomy for large vessel occlusion stroke: results from a multicenter cohort study

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