Persistent Worsening of Stroke Sequelae After Delayed Seizures

Bogousslavsky, Julien; Martín, R.; Régli, F; Despland, P. A.; Bolyn, Serge

doi:10.1001/archneur.1992.00530280073025

Cited by 84 publications

(36 citation statements)

References 17 publications

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“…In addition, prolonged exacerbation of the neurological sequelae of stroke by post-stroke partial epileptic seizures was reported in one study [41], persistent worsening of stroke sequelae after delayed seizures due to a direct effect of the seizure itself on the infarcted area in another study [42], and hemispheric brain damage secondary to unilateral status epilepticus was reported in a further neuropathological study [43]. …”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Very Early Seizures for In-Hospital Mortality in Atherothrombotic Infarction

Arboix¹,

Comes²,

Garcı́a-Eroles

et al. 2003

Eur Neurol

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We studied the influence of very early seizures (within 48 h of stroke onset) on in-hospital mortality in a cohort of 452 consecutive patients with atherothrombotic infarction. These patients were selected from 2,000 consecutive acute stroke patients registered in a prospective hospital-based stroke registry in Barcelona, Spain. A comparison of data between the nonseizure (n = 442) and seizure (n = 10) groups was made. Predictors of very early seizures were assessed by multivariate analysis. The in-hospital mortality rate was significantly higher in atherothrombotic stroke patients with very early seizures than in those without seizures (70 vs. 19.5%, p < 0.001). Independent predictors of in-hospital mortality included very early seizures, congestive heart failure, atrial fibrillation, 85 years of age or older, altered consciousness, dizziness, parietal and pons involvement, and respiratory and cardiac complications. After multivariate analysis, atherothrombotic infarction of occipital topography and decreased consciousness appeared to be independent predictors of atherothrombotic stroke with very early seizures. Very early seizures constitute an important risk factor for in-hospital mortality after atherothrombotic stroke.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Very Early Seizures for In-Hospital Mortality in Atherothrombotic Infarction

Arboix¹,

Comes²,

Garcı́a-Eroles

et al. 2003

Eur Neurol

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“…2,7 The incidence of SE after stroke either is low or is not cited at all in some reports. [1][2][3][4][5][17][18][19][20] Three studies reported the rate of SE as 19%, 17%, and 14%. 7,21,22 We found that SE occurred in 9% of all patients admitted for a PFS to our Neurology Department.…”

Section: Discussionmentioning

confidence: 99%

Status Epilepticus After Stroke

Velioğlu

Özmenoğlu

Boz

et al. 2001

Stroke

122

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Background and Purpose-The main objective of our study was to determine the risk and predictive factors of status epilepticus (SE) after stroke. Methods-From 1988 to 2000, 1174 patients were admitted to the Department of Neurology at the Karadeniz Technical University Farabi Hospital with first-time strokes. Of these, 180 patients had poststroke first-time seizures (PFSs). We followed these 180 PFS patients for an average of 3.7 years or until death to determine the occurrence rate of SE. By comparing these data with those of PFS patients without SE, we investigated whether there were significant differences. Results-A total of 17 of the 180 PFS patients (9%) had SE. There was no relationship between the occurrence of SE and stroke risk factors, stroke type (ischemic or hemorrhagic stroke), stroke topography and cause, cortical involvement, size of lesion, seizure type, or electroencephalographic findings. SE occurred more frequently among patients with a higher disability rating (Rankin scale Ͼ3; odds ratio, 4.36). Recurrent SE was identified in 5 of 17 patients with SE. In all 5 of these patients, the first episode of SE occurred within the first 7 days after stroke (early-onset SE). Statistical analysis demonstrated that early-onset SE was associated with a higher risk for SE recurrence (Pϭ0.003) and a higher mortality rate (Pϭ0.04). Conclusions-SE was not associated with a higher mortality rate but with higher functional disability. We also found that early-onset SE (within the first 7 days after stroke) was associated with a higher risk for SE recurrence and a higher mortality rate than late-onset SE (after 7 days after stroke).

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“…Also published were reports on stroke patients with worsening of the previous neurological deficit followed by partial epileptic seizures, then treated with various antiepileptic drugs, which were able to prevent further recurrence of seizures for more than a 1-year follow-up period [19]. …”

Section: Discussionmentioning

confidence: 99%

Antiepileptic Treatment in Patients with Early Postischemic Stroke Seizures: A Retrospective Study

Gilad¹,

Lampl²,

Eschel³

et al. 2001

Cerebrovasc Dis

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Early seizures caused by stroke are a common cause of epilepsy in adults. The protocol for treatment in such a case is not clear. Patients were studied retrospectively after early poststroke seizures. Two groups of patients were compared: one treated group included 35 patients who continued therapy for 2 years; the second group of 23 patients were untreated following a first attack, receiving anticonvulsive therapy only after a second seizure. The data of 61 patients (35 treated and 26 untreated) were analyzed. In the treated group, 24 patients were on treatment with carbamazepine, 9 with valproic acid and 2 with phenytoin. Seizure-free rate after 2 years was 85% in group I and 61% in group II (p = 0.042). Comparing the seizure rate and the event-free period (number/follow-up at risk) during the 2 years of no anticonvulsive therapy, both groups experienced about the same seizure rate (4.8 vs. 6.2%, p = 0.605) and similar seizure-free curve survival analysis (p = 0.85). We conclude that treatment of seizures immediately after the first attack after cerebral infarctions decreases the risk of recurrent seizure during the first 2 years of antiepileptic treatment. This subgroup of patients receiving antiepileptic medication immediately after the first poststroke seizure continues to be at the same rate of risk after treatment was stopped as the untreated group during the first 2 years. Antiepileptic therapy is an option in the medical management of poststroke seizure patients, but has no influence on the development of recurrent seizures after discontinuing medication.

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Persistent Worsening of Stroke Sequelae After Delayed Seizures

Cited by 84 publications

References 17 publications

Prognostic Value of Very Early Seizures for In-Hospital Mortality in Atherothrombotic Infarction

Prognostic Value of Very Early Seizures for In-Hospital Mortality in Atherothrombotic Infarction

Status Epilepticus After Stroke

Antiepileptic Treatment in Patients with Early Postischemic Stroke Seizures: A Retrospective Study

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