Seizure development after stroke

Mısırlı, Handan; Özge, Aynur; Somay, Göksel; Erdoğan, Neşe; Erkal, Hafize; Erenoğlu, Nuri Y.

doi:10.1111/j.1742-1241.2005.00782.x

Cited by 40 publications

(53 citation statements)

References 34 publications

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“…No differences between age and gender were found between patients with and without ES. These data are consistent with those reported in previous studies (Reith et al 1997;Labovitz et al 2001), although age younger than 65 years and male gender have been shown to be a risk factors for ES in some other reports (Olsen et al 1987;Misirli et al 2006). Consistently with the most recent studies (Labovitz et al 2001;Lamy et al 2003), hypertension, diabetes mellitus, smoking, hyperlipidemia, ischemic heart disease, atrial fi brillation or previous TIA were not associated with ES.…”

Section: Discussionsupporting

confidence: 92%

“…We did not observe an association between stroke etiology, particularly cardioembolic stroke, and the occurrence of ES. This is of interest as cardioembolic infarction has been a controversial risk factor for ES for years (Lesser et al 1985;Kittner et al 1990;Giroud et al 1994;Kraus et al 1998;Bladin et al 2000;Misirli et al 2006;So et al 2006).…”

Section: Discussionmentioning

confidence: 99%

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Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome

Barrios¹

2008

VHRM

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Background: Early seizure (ES) may complicate the clinical course of patients with acute stroke. The aim of this study was to assess the rate of and the predictive factors for ES as well the effects of ES on the clinical outcome at hospital discharge in patients with fi rst-ever stroke. Patients and methods: A total of 638 consecutive patients with fi rst-ever stroke (543 ischemic, 95 hemorrhagic), admitted to our Stroke Unit, were included in this prospective study. ES were defi ned as seizures occurring within 7 days from acute stroke. Patients with history of epilepsy were excluded. Results: Thirty-one patients (4.8%) had ES. Seizures were signifi cantly more common in patients with cortical involvement, severe and large stroke, and in patient with cortical hemorrhagic transformation of ischemic stroke. ES was not associated with an increase in adverse outcome (mortality and disability). After multivariate analysis, hemorrhagic transformation resulted as an independent predictive factor for ES (OR = 6.5; 95% CI: 1.95-22.61; p = 0.003). Conclusion: ES occur in about 5% of patients with acute stroke. In these patients hemorrhagic transformation is a predictive factor for ES. ES does not seem to be associated with an adverse outcome at hospital discharge after acute stroke.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome

Barrios¹

2008

VHRM

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“…Young age was an associated factor in a retrospective study of 6044 patients with first or recurrent stroke and in a large, hospital-based, retrospective cohort study of 1880 patients with first stroke. 4,24 Conversely, the association of seizures with old age has been reported, for instance, in a retrospective population-based study of 675 British patients with a minimum follow-up of 2 years. 3 In relation to our findings, we propose that younger patients are more likely to experience large cortical infarcts rather than small vessel disease-related lacunar events, and that this may contribute to subsequent epilepsy development.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Associations of Poststroke Epilepsy

Graham

Crichton

Koutroumanidis

et al. 2013

Stroke

179

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C erebrovascular disease is the most commonly identified cause of acute symptomatic seizures and secondary epilepsy in adults, underlying approximately 11% of epilepsy diagnoses. 1 The incidence and associations of poststroke epilepsy (PSE) are not well-established; many previous studies have investigated seizure episodes, rather than epilepsy diagnoses, with uncertainty frequently arising from varying definitions of seizure timing, selective recruitment, and short follow-up. [2][3][4][5] Hemorrhagic strokes, cortical lesions, and large lesions are most consistently associated with poststroke seizures, 6 defined as early or late, based on timing and differing pathophysiology.7-10 A wide range (2% to 67%) of patients has been reported for the risk of early or late seizures after ischemic stroke, 11 whereas intracerebral and subarachnoid hemorrhages have been associated with a range of between 8% and 15% over varying durations of follow-up. 6 There is insufficient evidence to reliably predict those who will have development of PSE and would benefit from prophylactic antiepileptic treatment. Of those with a single seizure, approximately half were observed to have progression to epilepsy in a well-designed study with a maximum follow-up of 6.5 years.3 Associations have been suggested with deep infarctions extending to subcortical structures and late onset of first seizure after ischemic stroke.2,12 PSE impairs self-reported vitality and physical and social functioning. 13 We used a population-based register in a multiethnic area of London, including hospital and community diagnoses of first stroke, to investigate the epidemiology and associations of PSE over 12 years, focusing on long-term rates and predictors of epilepsy. Methods Study PopulationStroke subjects were recruited from the South London Stroke Register, an ongoing longitudinal register of first-ever strokes in subjects of all ages in a multiethnic inner-city population of 271 817.14 Background and Purpose-To describe the epidemiology and associations of poststroke epilepsy (PSE) because there is limited evidence to inform clinicians and guide future research. Methods-Data were collected from the population-based South London Stroke Register of first strokes in a multiethnic innercity population with a maximum follow-up of 12 years. Self-completed forms and interviews notified study organizers of epilepsy diagnosis. Kaplan-Meier methods and Cox models were used to assess associations with sociodemographic factors, clinical features, stroke subtype, and severity markers. Results-Three thousand three-hundred ten patients with no history of epilepsy presented with first stroke between 1995 and 2007, with a mean follow-up of 3.8 years. Two-hundred thirteen subjects (6.4%) had development of PSE. PSE incidence at 3 months and 1, 5, and 10 years were estimated at 1.5%, 3.5%, 9.0%, and 12.4%, respectively. Sex, ethnicity, and socioeconomic status were not associations, but markers of cortical location, including dysphasia, visual neglect, and field defect, ...

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“…İleri yaşta epilepsi, (15,16). Yaşlı epileptiklerin etiyolojisinde ilk sırada SVH daha sonra nörodejeneratif hastalıklar, beyin tümörü, travma ve diğer nedenler gelmektedir (7,13).…”

Section: Discussionunclassified

“…Bulgularımız önceki çalışmaların sonuçlarına benzerdi (14)(15)(16)18). İnme sonrası kortikal etkilenme epileptik nöbetlerde belirli risk faktörü olmakla birlikte yapılan çalışmalarda sadece subkortikal tutulumun da nöbetlere yol açabildiği bildirilmiştir (16). Paradowski ve ark.…”

Section: Discussionunclassified

Epilepsy in the elderly

Balcı¹,

Mutlu²,

Özer³

et al. 2015

tnd

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Amaç: Epilepsi yaşlılarda sık görülen bir hastalıktır, ancak etiyolojisi, klinik sunumu, eşlik eden hastalıkları ve prognozu genç hastalardan farklıdır. Bu çalışmada epilepsi nedenleri, yaşlılarda nöbet tipleri, elektroensefalografi (EEG) bulguları araştırıldı. Gereç ve Yöntem:İlk epileptik nöbetini geçiren ve altmış beş yaş üzerinde 95 hasta retrospektif olarak değerlendirildi. Yaş, epilepsi tipi, EEG bulguları, manyetik rezonans görüntüleme ve/veya kranial tomografi bulguları, etiyoloji, eşlik eden hastalıklar ve verilen antiepileptik tedaviler değerlendirildi. Anah tar Ke li me ler: Epilepsi, nöbet tipi, EEG, tedavi, yaşlı hastalar Objective: Epilepsy is frequently seen in the elderly, but its etiology, clinical presentation, comorbidities, and prognoses are different than younger patients. In this study, we investigated types of seizures, electroencephalography (EEG) findings and the cause of epilepsy in the elderly. Materials and Methods:We retrospectively analyzed 95 patients who were 65 years old or older, and who had an epileptic seizure for the first time. Type of epilepsy, age, EEG findings, magnetic resonance imaging and/or cranial tomography findings, etiology, comorbidities and antiepileptic medication were evaluated. Results:The average age of our patients was 75, and 50 (56%) patients were male. Among 95 patients, 55 (58%) had focal seizures, 36 (38%) had generalized tonic-clonic seizures and 4 (4%) had convulsive status epilepticus. The frequency of focal interictal epileptiform activity was 32.6% patients. Seizures were responsive to treatment administered as monotherapy in 81 (85%) patients and as politherapy in 14 (15%) patients. Our study showed that cerebrovascular disease was the most common (63%) etiological cause identified. There was no significant relationship between age and frequency of seizures and EEG abnormalities. However, a significant correlation was found between age and comorbidities. Conclusion:Our results supported the focal seizure is the most common manifestation of epilepsy in the elderly. Cerebrovascular disease is the most common etiological cause of epilepsy in the elderly. Monotherapy is sufficient in the majority of patients. Continuous growth of the elderly population is increasing the need for accurate diagnosis and effective treatment. (Turkish Journal of Neurology 2015; 21:62-7)

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Seizure development after stroke

Cited by 40 publications

References 34 publications

Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome

Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome

Incidence and Associations of Poststroke Epilepsy

Epilepsy in the elderly

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