Exames subsidiários preditivos de crises epilépticas após acidente vascular cerebral isquêmico

Fukujima, Márcia Maiumi; Cardeal, José Osmar

doi:10.1590/s0004-282x1997000100007

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…In our study, extensive lesions (relative risk 3.6) seen on tomography and involvement of more than one cerebral lobe predominated in the patients with spasticity, although there is no consensus regarding the relationship between the size and number of lesions seen on tomography and the occurrence of spasticity 17,18,23 .…”

Section: Discussioncontrasting

confidence: 49%

“…The tomographic data on the other 62 patients were not analyzed because of loss or damage to the films. The tomographic data were evaluated with regard to: (1) the hemisphere injured (side injured); (2) number of lesions: single or multiple; (3) extent of the lesion: extensive (>5 cm) or not extensive (<5 cm) 23 ; (4) cerebral topography: frontal, parietal, temporal, occipital, thalamic, cerebellar, insular or more than one lobe; (5) involvement of the white matter; (6) involvement of the cerebral cortex; and (7) vascular territory. Two investigators analyzed the tomographic data, and possible discrepancies in the analyses were resolved by a third investigator or by means of a meeting to establish a consensus.…”

Section: Tomographic Datamentioning

confidence: 99%

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Predictive factors for spasticity among ischemic stroke patients

Moura

Fukujima

Aguiar³

et al. 2009

Arq. Neuro-Psiquiatr.

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-Spasticity is a determining for functional loss following ischemic stroke. Objective: To detect possible predictive factors for its occurrence. Method: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. Results: Spasticity was noted more frequently among patients who underwent physiotherapy (p<0.0001; OR=19.4; 95% CI: 4.4-84.5), those who underwent such treatment for long periods (p=0.028; OR=4.80; 95% CI: 1.1-8.3) and those with manual work (p=0.041; OR=2.2; 95% CI: 1.02-4.6), lower income (p=0.038), pain complaints (p<0.0001; OR=107.0; 95% CI: 13.5-847.3), appearance of pain at the same time as spasticity (p<0.0001), previous vascular disease (p=0.001; OR=4.2; 95% CI: 1.7-10.3), muscle weakness (p<0.0001; OR=91.9; 95% CI: 12.0-699.4), extensive lesions as seen on tomography (p=0.01) and lesions affecting more than one cerebral lobe (p=0.018). Manual work had a relative risk of 2.9; previous stroke 3.9, and extensive lesion 3.6. Conclusion: Spasticity affected 25% of the patients, and was associated with: manual work, previous stroke, extensive lesions, decrease in individual income, underwent physiotherapy, underwent physiotherapy for longer period, pain complaints, the pain started simultaneously with the spasticity, presented changes in strength.KEY WORDS: spasticity, stroke, cerebral infarct, physiotherapy. Fatores preditivos para espasticidade após acidente vascular cerebralResumo -A espasticidade é fator determinante para perda funcional após o acidente vascular cerebral isquêmico (AVCI). Objetivo: Detectar possíveis fatores preditivos para a ocorrência da espasticidade. Método: Foram analisados dados demográficos, clínicos e tomográficos de 146 pacientes pós-AVCI. Resultados: Na análise univariada a espasticidade foi notada com maior freqüência em pacientes que realizaram fisioterapia (p<0,0001; OR=19,4; 95% CI: 4,4-84,5), com maior tempo de duração desse tratamento (p=0,028; OR=4,80; 95% CI: 1,1-8,3) e que realizavam trabalho braçal (p=0,041; OR=2,2; 95% CI: 1,02-4,6), renda menor (p=0,038), referência de dor (p<0,0001; OR=107,0; 95% CI: 13,5-847,3) e seu aparecimento simultâneo à espasticidade (p<0,0001), acidente vascular cerebral (AVC) pregresso (p=0,001; OR=4,2; 95% CI: 1,7-10,3), fraqueza muscular (p<0,0001; OR=91,9; 95% CI: 12,0-699,4), lesão tomográfica extensa (p=0,01) e lesão afetando mais de um lobo cerebral (p=0,018). Na análise de regressão multivariada a atividade braçal apresentou risco relativo de 2,9; acidente vascular cerebral prévio com risco relativo de 3,9 e lesão tomográfica extensa risco relativo de 3,6. Conclusão: A espasticidade afetou um quarto da população estudada e esteve associada ao trabalho braçal, AVC pregresso, lesões tomográficas extensas, diminuição da renda individual, realização de fisioterapia, realização de fisioterapia por um período maior, presença de dor, surgimento da dor simultânea à espasticidade e alteração da força. PALAVRAS-CHAVE: espasticidade, acidente vascular cerebral, infarto cerebral isquêmico, fisioterapia.

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Section: Discussioncontrasting

confidence: 49%

Section: Tomographic Datamentioning

confidence: 99%

Predictive factors for spasticity among ischemic stroke patients

Moura

Fukujima

Aguiar³

et al. 2009

Arq. Neuro-Psiquiatr.

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“…Chamou-nos a atenção a associação entre tabagismo e etilismo ao grupo de epilépticos 23 ; e dentre os exames laboratoriais, destacaram-se quanto à preditividade das crises epilépticas após AVCI, o conjunto de presença de lesão extensa à TC e alteração do EEG (principalmente do tipo alentecimento focai) 24 .…”

Section: Discussionunclassified

Características das crises epilépticas após acidente vascular cerebral isquêmico

Fukujima

Cardeal

1997

Arq. Neuro-Psiquiatr.

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RESUMO -Os infartos cerebrais constituem uma das mais importantes causas de epilepsia de início tardio. Foram estudados 35 pacientes que apresentaram crises epiléptica com início 24 horas após a instalação do acidente vascular cerebral isquêmico (AVCI) e que tiveram pelo menos 1 recorrência da crise, a fim de definir as principais características dessas crises e correlacioná-las aos principais achados clínicos e laboratoriais. O tempo entre a instalação do AVCI e a primeira crise foi de 3 a 1650 dias, com predomínio (89%) de crises de instalação tardia (>14 dias); houve um pico de freqüência no período de 6 a 12 meses após a instalação do AVC. Crises parciais foram mais freqüentes (31/35) do que crises primariamente generalizadas, e estado de mal epiléptico só ocorreu em 3 casos. A maioria (30/35) apresentou crises pouco freqüentes (< 1 crise/mês). Não houve associação entre tipo de crise e intervalo de tempo entre ela e a instalação do AVCI, nem com a freqüência. A alteração eletrencefalográfica mais freqüente foi alentecimento focai da atividade elétrica cerebral. Todos os pacientes obtiveram controle das crises com monoterapia. PALAVRAS-CHAVE: infarto cerebral, crise epiléptica, epilepsia tardia. Characteristics of epileptic seizures after ischemic strokeABSTRACT -Cerebral infarctions are one of the most important causes of late onset epilepsy. We have studied 35 patients who presented epileptic seizures after ischemic stroke. All of them had the first seizure at least 24 hours after the stroke, and they had at least one recurrence of seizure. The objective was to determine the main characteristics of these seizures and to correlate them to clinical and laboratorial findings. The interval between the stroke and the first seizure was 3 to 1650 days. Late onset seizures (>14 days) were present in 89%, they occurred predominantly 6 to 12 months after stroke. Partial seizures (31/35) were more frequent than generalized ones. Status epilepticus occurred in only 3 cases. Most of the patients (30/35) had occasional seizures (<, 1 seizure monthly). There were no association between seizure type and the time interval between the stroke and the first seizure, neither with the seizure frequency. The most frequent EEG finding was focal slowing oi cerebral activity. Pharmacological control was easily obtained. No patient needed more than one drug for seizure control.KEY WORS: cerebral infarction, late onset epilepsy, epileptic seizure.Estima-se que somente 30% das pessoas que sofrem acidente vascular cerebral (AVC) recuperem todas as funções afetadas. As principais conseqüências dos AVC são sequela motora e de linguagem. Porém, várias outras complicações podem ocorrer, entre elas, as crises epilépticas.

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Exames subsidiários preditivos de crises epilépticas após acidente vascular cerebral isquêmico

Cited by 2 publications

References 22 publications

Predictive factors for spasticity among ischemic stroke patients

Predictive factors for spasticity among ischemic stroke patients

Características das crises epilépticas após acidente vascular cerebral isquêmico

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