Seizures and epilepsy in patients with lacunar strokes

Reuck, Jacques De; Nagy, Endre; Maele, Georges Van

doi:10.1016/j.jns.2007.06.004

Cited by 28 publications

(28 citation statements)

References 34 publications

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“…Overall, there is no evidence that cardiac-embolic infarcts are more prone to seizures than thrombo-embolic ones, although seizures due to recurrent infarction have mainly a cardiac-embolic source [5]. Patients with a partial anterior circulation syndrome/infarct have an increased risk [6], while in those with a lacunar syndrome/infarct, the seizures and the epilepsy probably have another cause [7]. …”

Section: Introductionmentioning

confidence: 99%

The Cortical Involvement of Territorial Infarcts as a Risk Factor for Stroke-Related Seizures

et al. 2007

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Background: The cortical involvement of territorial infarcts is considered to be a significant risk factor for the development of early- as well as late-onset seizures. However, it is not known which cortical regions are more susceptible to the development of stroke-related seizures. Patients and Methods: In this retrospective study of 687 patients with territorial infarcts, 184 with stroke-related seizures were compared to 503 without seizures. The extent and the location of the infarcts were determined by computed tomography (CT) scans and/or magnetic resonance imaging (MRI) scans of the brain. The infarcts of the seizure and the non-seizure group were compared on digital cerebral vascular maps by superimposing the CT and/or MRI slices. Results: In patients with late-onset seizures, the infarcts were significantly more frequent in the temporal and parietal branches of the middle cerebral artery in comparison to the non-seizure group. In patients with early-onset seizures and in those with seizures due to a recurrent stroke, the territory of the temporal and occipital branches of the middle cerebral artery was the predilection side of the infarcts. Generalized tonic-clonic seizures occurred mainly in cases of infarction in the deep territory of the middle cerebral and of the anterior choroidal artery. Status epilepticus was significantly correlated with infarcts in the posterior temporal region. Conclusion: Some infarct regions are the sides of predilection for stroke-related seizures according to their type and their onset-time.

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Section: Introductionmentioning

confidence: 99%

The Cortical Involvement of Territorial Infarcts as a Risk Factor for Stroke-Related Seizures

et al. 2007

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“…The results are somewhat different from those of our previous study, in which no statistical difference in average MMSE score between the seizure and nonseizure group was demonstrated. This can be explained by the low number of tested patients in the control group [9]. Also, the actual difference in smokers is due to the higher number of included patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, the relationship between the seizures and the lacunar infarcts is uncertain [9]. While patients with a partial anterior circulation syndrome as the clinical presentation [10] and large cortical infarcts in the temporal and parietal lobes [11, 12] have a high risk of developing early- as well as late-onset seizures, this is not the case in patients with lacunar strokes [9]. In the latter, the seizures occur generally very late after the onset of the stroke [13].…”

Section: Introductionmentioning

confidence: 99%

“…Our previous positron emission tomography (PET) study showed that patients with lacunes and white matter changes who developed seizures have more decreased blood flow and oxygen metabolism in the cerebral cortex, without differences in the deep structures, compared to those without seizures [16]. In a further previous study, we were unable to demonstrate differences in the number and location of lacunes or in the severity of white matter changes on computed tomography (CT) scan between patients with and without seizures [9]. …”

Section: Introductionmentioning

confidence: 99%

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Cognitive Impairment and Seizures in Patients with Lacunar Strokes

Reuck

Maele²

2008

Eur Neurol

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Background: Lacunar infarcts and white matter changes have been linked to cognitive impairment. Patients with lacunar strokes can also develop seizures, although the relationship between the two remains unclear. The present study investigates whether seizures in patients with lacunar infarcts are related to the strokes or to an underlying neurodegenerative disorder leading to cognitive impairment. Methods: The demographic features, vascular risk factors and scores on the National Institutes of Health Stroke Scale (NIHSS) on admission for the stroke and on the modified Rankin scale on discharge, as well as on the Mini-Mental State Examination (MMSE), were determined in patients with a lacunar stroke. They were compared between 44 patients with and 248 without subsequent seizures. Results: Patients with seizures had a lower main NIHSS score (p = 0.00133) and a more severe MMSE score (p < 0.001). They remained significantly more dependent (p = 0.019) after hospital discharge. Smoking, as a vascular risk factor, appeared to occur less frequently in seizure patients (p = 0.039). On logistic regression analysis, only NIHSS and MMSE scores remained independent variables. Conclusions: Seizure occurrence in patients with a lacunar infarct is not related to the severity of the stroke but rather to the degree of cognitive impairment. The present study suggests that the seizures are not due to lacunar infarcts but are more probably the expression of an underlying neurodegenerative process that is also responsible for the mental deterioration.

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“…Follow up records of these patients were available for three months only, during this period neither recurrent seizure nor mortality was observed. The clinical characteristics, functional outcomes than hemorrhagic ones, the majority of stroke-related epileptic insults are due to cerebral infarction [3][4][5][6]. Post-stroke seizure is defined as "single or multiple convulsive episode/s (fit/s) after stroke and thought to be related to reversible or irreversible cerebral damage due to stroke regardless of time of onset following the stroke" [7].…”

Section: Frequency and Outcomes Of Early Onset Seizures After Ischemimentioning

confidence: 99%