Outcome and predictive factors in post-stroke seizures: A retrospective case-control study

Castro-Apolo, Ramiro; Huang, Josephine F.; Vinan-Vega, Myrian; Tatum, William O.

doi:10.1016/j.seizure.2018.09.007

Cited by 22 publications

(20 citation statements)

References 49 publications

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“…Our results support the findings of several smaller studies that did not find an increased number of acute symptomatic seizures in patients undergoing IVT 26,[28][29][30]32 . Some of these studies presented more clinical details of patients suffering from acute symptomatic seizures, but the overall numbers of patients with seizures were limited in most studies, ranging from n = 3 to n = 25.…”

Section: Discussionsupporting

confidence: 92%

“…Frequencies of acute symptomatic seizures noted by us are similar to those in several other studies in patients who underwent recanalization treatments, ranging between 1.2 and 3.8% 25,29,31,32 , with only two studies that reported higher frequencies between 8.1 and 23.4% 26,30 . These discrepancies are probably due to differences in seizure detection, classification and a referral bias in single-center studies with populations from tertiary stroke-centers.…”

Section: Discussionsupporting

confidence: 88%

“…Recently, a number of publications have suggested that recanalization attempts after ischemic stroke with either IVT or MT could increase the risk of acute symptomatic seizures or subsequent epilepsy [23][24][25] . However, the data supporting this notion are from studies in which a limited number of patients suffered from acute seizures, and other reports could not show a correlation between recanalization of an arterial cerebral vessel and the occurrence of acute symptomatic seizures [26][27][28][29][30] . In addition, the vast majority of these studies only investigated IVT therapy, reporting a risk for acute symptomatic seizures after rt-PA treatment between 1-4%.…”

Section: Scientific Reportsmentioning

confidence: 96%

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Intravenous thrombolysis or mechanical thrombectomy do not increase risk of acute symptomatic seizures in patients with ischemic stroke

Zöllner

Misselwitz

Mauroschat

et al. 2020

Sci Rep

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Recent data have suggested that performing recanalizing therapies in ischemic stroke might lead to an increased risk of acute symptomatic seizures. This applies to both intravenous thrombolysis and mechanical thrombectomy. We therefore determined the frequency of acute symptomatic seizures attributable to these two recanalization therapies using a large, population-based stroke registry in Central Europe. We performed two matched 1:1 case–control analyses. In both analyses, patients were matched for age, stroke severity on admission and pre-stroke functional status. The first analysis compared patients treated with intravenous thrombolysis to a non-recanalization control group. To isolate the effect of mechanical thrombectomy, we compared patients with both mechanical thrombectomy and intravenous thrombolysis to those with only intravenous thrombolysis treatment in a second analysis. From 135,117 patients in the database, 13,356 patients treated with only intravenous thrombolysis, and 1013 patients treated with both intravenous thrombolysis and mechanical thrombectomy were each matched to an equivalent number of controls. Patients with intravenous thrombolysis did not suffer from clinically apparent acute symptomatic seizures significantly more often than non-recanalized patients (treatment = 199; 1.5% vs. control = 237; 1.8%, p = 0.07). Mechanical thrombectomy in addition to intravenous thrombolysis also was not associated with an increased risk of acute symptomatic seizures, as the same number of patients suffered from seizures in the treatment and control group (both n = 17; 1.7%, p = 1). In a large population-based stroke registry, the frequency of clinically apparent acute symptomatic seizures was not increased in patients who received either intravenous thrombolysis alone or in conjunction with mechanical thrombectomy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Section: Scientific Reportsmentioning

confidence: 96%

See 1 more Smart Citation

Intravenous thrombolysis or mechanical thrombectomy do not increase risk of acute symptomatic seizures in patients with ischemic stroke

Zöllner

Misselwitz

Mauroschat

et al. 2020

Sci Rep

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“…Graham et al showed that the 10-year estimate of poststroke seizure recurrence from either total anterior circulation infarct, partial anterior circulation infarct, or posterior circulation infarct was 28.7%, 13.4%, and 4.8%, respectively [22]. Studies have found that ischemic strokes involving the cortex, especially those with hemorrhagic transformation, were at a higher risk of seizures [19, 23–25]. Others have looked at such as NIH stroke scale (NIHSS), infarct size, and etiology of the ischemic stroke [17].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Seizure Recurrence after Acute Symptomatic Seizures in Ischemic Stroke Patients

George

Punia

Natteru

et al. 2019

Neuroscience Journal

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Purpose Seizure is a well-recognized complication of both remote and acute ischemic strokes. Predictors of seizure recurrence and epilepsy in patients with ischemic stroke who develop acute symptomatic seizures (ASyS) on continuous electroencephalography (cEEG) have not been well studied. Methods We present a five-year retrospective study of acute and remote ischemic stroke patients who developed ASyS on cEEG. We then identified risk factors for the development of seizure recurrence. Results Sixty-five patients with ischemic stroke and ASyS were identified and reviewed. All ASyS were noted to be nonconvulsive seizures. Clinical recurrence of seizures was identified in 19 of these patients (29.2%) at follow-up. Rate of seizure recurrence was higher in remote ischemic stroke patients (84.2%), compared to acute ischemic stroke patients (15.8%, p = 0.0116, OR 0.17, 95% CI 0.049–0.65). Sharp waves/spikes on follow-up EEG significantly correlated with seizure recurrence (p = 0.006, OR 0, 95% CI 0–0.3926). Patients discharged on ≥3 antiepileptic drugs (AEDs) were at a higher risk of having seizure recurrence (p = 0.0015, OR 0.05, 95% CI 0.0089–0.37). Conclusion We identified risk factors of seizure recurrence in patients with ASyS as remote ischemic stroke, requiring multiple AEDs, and the presence of sharp waves on follow-up EEG. This study highlights the usefulness of cEEG in evaluating patients with acute or remote strokes.

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“…Stroke merupakan penyebab kejang yang paling umum pada lansia. 9,10 Hasil penelitian ini didukung oleh penelitian Tanaka et al 11 yang melaporkan insiden kejang pasca stroke lebih tinggi pada pasien berusia <65 tahun dibandingkan 85 tahun ke atas. Faktor-faktor risiko yang diketahui berpe-ran pada usia <65 tahun untuk terjadinya kejang pasca stroke ialah hiponatremia, subtipe stroke hemoragik, konsumsi alkohol, keterlibatan kortikal, dan keparahan stroke.…”

Section: Pendahuluanunclassified

Profil Kejang Pasca Stroke pada Pasien Rawat Inap Periode Juli 2018 - Juni 2019 di RSUP Prof. Dr. R. D. Kandou Manado

Tombeng¹,

Mahama²,

Kembuan³

2020

MSJ

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Stroke is the most common cause of seizures in elderly population. The higher the number of stroke patients, the higher the predicted level of likelihood of the prevalence of post-stroke seizures. This study was aimed to obtain the profile of post-stroke seizures among hospitalized patients from July 2018 to June 2019 at Prof. Dr. R. D. Kandou Hospital Manado. This was a descriptive and retrospective study. The results showed 24 patients who met the inclusion criteria. Post-stroke seizures were more common in males than in females. Based on age, most patients with post-stroke seizures were in the age range of 45-54 years. Many post-stroke seizure patients worked as housewives. Most post-stroke seizure patients suffered from focal seizures with impaired awareness. Among patients with post-stroke seizures, the number of patients with ischemic stroke type was higher than of patients with hemorrhagic stroke type. In conclusion, the majority of patients were males, aged 45-54 years, had focal seizures and impaired awareness, as well as ischemic stroke. The most common job of the patients was housewifery.Keywords: stroke, seizures, post-stroke seizures Abstrak: Stroke merupakan penyebab kejang yang paling umum pada populasi lansia. Semakin tinggi data yang menunjukkan jumlah pasien stroke, maka tingkat kemungkinan prevalensi terjadinya kejang pasca stroke juga diprediksi akan meningkat. Penelitian ini bertujuan untuk mengetahui profil kejang pasca stroke pada pasien rawat inap periode Juli 2018-Juni 2019 di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif. Hasil penelitian memperoleh 24 pasien yang memenuhi kriteria inklusi. Jumlah pasien kejang pasca stroke lebih banyak pada laki-laki dibandingkan perempuan. Berdasarkan usia pasien kejang pasca stroke terbanyak berada dalam rentang usia 45-54 tahun. Berdasarkan pekerjaan, pasien kejang pasca stroke terbanyak bekerja sebagai ibu rumah tangga. Sebagian besar pasien kejang pasca stroke mengalami kejang fokal dengan kesadaran terganggu. Jumlah pasien kejang pasca stroke dengan tipe stroke iskemik lebih banyak dibandingkan tipe stroke hemoragik. Simpulan penelitian ini ialah mayoritas pasien dengan kejang pasca stroke berjenis kelamin laki-laki, berusia 45-54 tahun, tipe kejang fokal dengan kesadaran terganggu, dan tipe stroke iskemik. Pekerjaan yang terbanyak didapatkan ialah ibu rumah tangga.Kata kunci: stroke, kejang pasca stroke

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Outcome and predictive factors in post-stroke seizures: A retrospective case-control study

Abstract: The size of anterior infarction, presence of blood products within the infarct bed, and especially LN predicted PSS.

Cited by 22 publications

References 49 publications

Intravenous thrombolysis or mechanical thrombectomy do not increase risk of acute symptomatic seizures in patients with ischemic stroke

Intravenous thrombolysis or mechanical thrombectomy do not increase risk of acute symptomatic seizures in patients with ischemic stroke

Predictors of Seizure Recurrence after Acute Symptomatic Seizures in Ischemic Stroke Patients

Profil Kejang Pasca Stroke pada Pasien Rawat Inap Periode Juli 2018 - Juni 2019 di RSUP Prof. Dr. R. D. Kandou Manado

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