Late-onset seizures as a predictor of subsequent stroke

Cleary, Paul; Shorvon, Simon; Tallis, Raymond

doi:10.1016/s0140-6736(04)15946-1

Cited by 210 publications

(143 citation statements)

References 16 publications

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“…5 Our study found that status epilepticus presented as a first seizure in elderly patients in 21.6% of cases, and among those, 61.7% had recurrent seizure. 11,12 Our study found, as other studies, that epileptiform activity on an EEG was a risk factor for recurrent seizure, 11 and nonspecific abnormality on EEG were the main risk factors of recurrent seizure.…”

Section: Resultssupporting

confidence: 79%

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Gopi¹,

Chowdary²

2018

jebmh

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BACKGROUNDThe annual incidence is 85 per 1,00,000 for people aged 65-69 years and 135 per 1,00,000 for those aged over 80 years. Epilepsy in older patients poses several additional problems for the provision of services compared with the rest of the population as diagnostic difficulties and polypharmacy. The aim of the study is to-1. Know the various causes of seizures, clinical profile and correlation between neurological imaging and VEEG characteristics. 2. Know the differences between the aetiologies of seizures in young age and elderly >65 years.

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Section: Resultssupporting

confidence: 79%

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Gopi¹,

Chowdary²

2018

jebmh

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“…11 Searching these patients' records from the date of diagnosis of first seizure for subsequent diagnoses of stroke enabled them to calculate an OR for the risk of clinical stroke in LOE patients of 2.89 (95% CI 2.45 to 3.41).…”

Section: Occult Cerebrovascular Disease and Late-onset Epilepsy: Evidmentioning

confidence: 99%

“…Thus, stroke risk may currently not be substantially affected by any reduction in action of statins potentially associated with enzyme inducing AEDs. Furthermore, given that the relative hazard of stroke after the onset of LOE was noted to be constant over time, 11 it seems unlikely that incident stroke risk in LOE is prominently related to the duration of AED exposure. In addition, as discussed above, radiologic CVD is known to be more prevalent in patients with LOE by comparison with age-matched controls before AED exposure.…”

Section: Antiepileptic Drug Treatment and Vascular Riskmentioning

confidence: 99%

Late-Onset Epilepsy and Occult Cerebrovascular Disease

Gibson

Hanby

Al–Bachari

et al. 2014

J Cereb Blood Flow Metab

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The interface between cerebrovascular disease (CVD) and epilepsy is complex and multifaceted. Late-onset epilepsy (LOE) is increasingly common and is often attributed to CVD, and is indeed associated with an increased risk of stroke. This relationship is easily recognizable where there is a history of stroke, particularly involving the cerebral cortex. However, the relationship with otherwise occult, subcortical CVD is currently less well established yet causality is often invoked. In this review, we consider the diagnosis of LOE in clinical practice-including its behaviour as a potential mimic of acute ischemic stroke and transient ischemic attack; evidence for an association between occult CVD and LOE; and potential mechanisms of epileptogenesis in occult CVD, including potential interrelationships between disordered cerebral metabolism and perfusion, disrupted neurovascular unit integrity, blood-brain barrier dysfunction, and inflammation. We also discuss recently recognized issues concerning antiepileptic drug treatment and vascular risk and consider a variety of less common CVD entities associated with seizures.

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“…4 To clarify the effect of hyper-tHcy on retinal vessel diameters, we investigated whether hyper-tHcy is associated with retinal vascular caliber changes in an epileptic population exhibiting hyper-tHcy. As literature data support the view that patients with epilepsy exhibit an increased risk for stroke, 5 early knowledge of the retinal vascular caliber might allow a prompt initiation of therapy to prevent stroke.…”

Section: Introductionmentioning

confidence: 81%

Is retinal assessment useful in epileptic patients with hyperhomocysteinemia?

Belcastro

Striano

Ciampa

et al. 2008

Eye

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Purpose The arteriole-to-venule ratio (AVR) is widely used for investigating subclinical cerebral microangiopathy. The possible occurrence of retinal vascular caliber changes was investigated in a population of hyperhomocysteinaemic (plasma total homocysteine (tHcy) 413 lmol/l) adult epileptic patients. Methods Retinal photographs of cases and controls were evaluated for generalized narrowing of the retinal arterioles, measured as AVR, by graders masked to case-control status using standardized protocols. Plasma total homocysteine (tHcy) levels were assayed by HPLC. Results Sixty-seven patients (36M/31F, 36.4±7.5 years of age; mean level of tHcy 22.8±11.4 lmol/l), and 75 control subjects (42M/33F, 35.4±8.5 years of age; mean level of tHcy 7.8 ± 2.3 lmol/l) were enroled. No retinal caliber changes were detected in any patient and healthy subject. The analysis of retinal photographs failed to identify any difference in the venular diameters, arteriolar diameters, and AVR measurements between the two groups (P ¼ 0.98). Conclusions we showed that adult hyperhomocysteinaemic epileptic patients do not show any changes in retinal vascular caliber assessed by the measurement of AVR.

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Late-onset seizures as a predictor of subsequent stroke

Cited by 210 publications

References 16 publications

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Late-Onset Epilepsy and Occult Cerebrovascular Disease

Is retinal assessment useful in epileptic patients with hyperhomocysteinemia?

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