Multifactorial Predictors of Late Epileptic Seizures Related to Stroke: Evaluation of the Current Possibilities of Stratification Based on Existing Prognostic Models—A Comprehensive Review

Wiśniewski, Adam; Jatužis, Dalius

doi:10.3390/ijerph18031079

Cited by 4 publications

(2 citation statements)

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“…Some authors investigated the radiological predictors of post-stroke epilepsy. Similar to what was stated above, larger lesions and cortical involvement in imaging are independent factors for seizures occurrence [ 55 ]. In particular, involvement of the parietal-temporal cortex, supramarginal gyrus, and superior temporal gyrus seems to predispose more to PSE [ 8 , 9 , 56 ].…”

Section: Late Seizuressupporting

confidence: 73%

Epilepsy in Cerebrovascular Diseases: A Narrative Review

Neri

Gasparini

Pascarella

et al. 2023

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Background: Epilepsy is a common comorbidity of cerebrovascular disease and an increasing socioeconomic burden. Objective: We aimed to provide an updated comprehensive review on the state of the art about seizures and epilepsy in stroke, cerebral haemorrhage and leukoaraiosis. Methods: We selected English-written articles on epilepsy, stroke, and small vessel disease up until December 2021. We reported the most recent data about epidemiology, pathophysiology, prognosis and management for each disease. Results: The main predictors for both ES and PSE are the severity and extent of stroke, the presence of cortical involvement and hemorrhagic transformation, while PSE is also predicted by younger age at stroke onset. Few data exist on physiopathology and seizure semiology, and no randomized controlled trial has been performed to standardize the therapeutic approach to post-stroke epilepsy. ConclusioN: Some aspects of ES and PSE have been well explored, particularly epidemiology and risk factors. On the contrary, few data exist on physiopathology, and existing evidence is mainly based on studies on animal models. Little is also known on seizure semiology, which may also be difficult to interpret by non-epileptologists. Moreover, the therapeutic approach needs standardization as regards indications and the choice of specific ASMs. Future research may help to better elucidate these aspects.

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Section: Late Seizuressupporting

confidence: 73%

Epilepsy in Cerebrovascular Diseases: A Narrative Review

Neri

Gasparini

Pascarella

et al. 2023

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“…A search for scientific publication in the health sciences was initiated in November 2021 in the electronic databases PubMed, Scopus, EMBASE, LILACS, BVS, Cochrane, CENTRAL, and Google Scholar, which included original studies published in English or Spanish for the period between 2010 and 2020. Furthermore, some references [20][21][22] were examined to feed our own database.…”

Section: Sources Of Informationmentioning

confidence: 99%

Risk Factors Associated with Epilepsy Related to Cerebrovascular Disease: A Systematic Review and Meta-Analysis

Mafla-Mendoza,

Paredes-Urbano,

Gea-Izquierdo

2023

NDT

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Background and Objective: Stroke is one of the most frequent neurological syndromes in the adult population and the cause of 10% of all diagnosed epilepsies. It is attributed to the origin of up to 50% of them in adults >60 years of age. Although a few risk factors have been described and considered when modeling predictive tools, this aspect is still clinically complex. The objective of this study is to describe and compare predictor scales of post stroke epilepsy (PSE) in adult patients with better performance. Methods: A systematic review and meta-analysis were performed of studies published between 2010 and 2020 and found in PubMed, Scopus, EMBASE, LILACS, BVS, Google Scholar, and CENTRAL databases. Sixteen studies were included with a total of 298,694 patients with a diagnosis of stroke, 5590 presented late seizures (LS). Results: Hemorrhage, cortical involvement, and early seizure were the elements most associated with the risk of presenting late seizures. The SeLECT score demonstrated a low risk of bias with a high predictive ability in patients with ischemic stroke (AUC: 0.77 [95% CI: 0.71-0.82]). In patients with hemorrhagic stroke, the CAVE score demonstrated adequate predictive ability (AUC: 0.81 [95% CI: 0.76-0.86]), but an uncertain risk of bias. Research has established risk factors for post ictal epilepsy; however, the numerous ways of assessing data in studies and the difference in their designs make the task of producing a predictive scale that covers the most important risk factors and is reliable for application in the clinical setting, regardless of stroke etiology, very arduous. Conclusion: Hemorrhage, cortical involvement, and early seizure are associated with an increased risk of post ictal epilepsy. Also, elements such as age, traditional vascular risk factors, and functional assessment failed to reflect statistical significance. Finally, further research is required to refine the available predictive tools.

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