Advances in the Development of Biomarkers for Poststroke Epilepsy

Liang, Mengke; Zhang, Liren; Geng, Zhi

doi:10.1155/2021/5567046

Cited by 9 publications

(7 citation statements)

References 70 publications

(77 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additionally, the presence of the CD40/CD40L system, associated with seizure susceptibility, further contributes to inflammatory mechanisms. 41,42 In the clinical field, the studies included in this meta-analysis have not shown evidence supporting the prophylactic use of antiseizure medications in the post stroke setting. Serafini et al 32 suggested that patients with hemorrhagic stroke could benefit from the antiseizure drugs; Tanaka et al 34 evaluated different families of antiepileptic drugs and conclude that valproic acid does not improve prognosis; and Yamada et al 36 mentioned that prophylactic antiepileptic therapy of short duration could be beneficial in high-risk patients with intracerebral hematomas, or with at least two factors identified in their study.…”

Section: Discussionmentioning

confidence: 91%

Risk Factors Associated with Epilepsy Related to Cerebrovascular Disease: A Systematic Review and Meta-Analysis

Mafla-Mendoza,

Paredes-Urbano,

Gea-Izquierdo

2023

NDT

View full text Add to dashboard Cite

Background and Objective: Stroke is one of the most frequent neurological syndromes in the adult population and the cause of 10% of all diagnosed epilepsies. It is attributed to the origin of up to 50% of them in adults >60 years of age. Although a few risk factors have been described and considered when modeling predictive tools, this aspect is still clinically complex. The objective of this study is to describe and compare predictor scales of post stroke epilepsy (PSE) in adult patients with better performance. Methods: A systematic review and meta-analysis were performed of studies published between 2010 and 2020 and found in PubMed, Scopus, EMBASE, LILACS, BVS, Google Scholar, and CENTRAL databases. Sixteen studies were included with a total of 298,694 patients with a diagnosis of stroke, 5590 presented late seizures (LS). Results: Hemorrhage, cortical involvement, and early seizure were the elements most associated with the risk of presenting late seizures. The SeLECT score demonstrated a low risk of bias with a high predictive ability in patients with ischemic stroke (AUC: 0.77 [95% CI: 0.71-0.82]). In patients with hemorrhagic stroke, the CAVE score demonstrated adequate predictive ability (AUC: 0.81 [95% CI: 0.76-0.86]), but an uncertain risk of bias. Research has established risk factors for post ictal epilepsy; however, the numerous ways of assessing data in studies and the difference in their designs make the task of producing a predictive scale that covers the most important risk factors and is reliable for application in the clinical setting, regardless of stroke etiology, very arduous. Conclusion: Hemorrhage, cortical involvement, and early seizure are associated with an increased risk of post ictal epilepsy. Also, elements such as age, traditional vascular risk factors, and functional assessment failed to reflect statistical significance. Finally, further research is required to refine the available predictive tools.

show abstract

Section: Discussionmentioning

confidence: 91%

Risk Factors Associated with Epilepsy Related to Cerebrovascular Disease: A Systematic Review and Meta-Analysis

Mafla-Mendoza,

Paredes-Urbano,

Gea-Izquierdo

2023

NDT

View full text Add to dashboard Cite

show abstract

“…Как у больных с ишемическим инсультом с развитием эпилептических припадков, так и у пациентов с наличием эпилептических припадков на фоне хронической ИГМ без острых сосудистых событий выявлено превалирование корковой локализации очагов ишемии. Связь между корковой локализацией очага инфаркта с развитием эпилептических приступов показана во многих исследованиях [7,[9][10][11][12][13][14][15][16].…”

Section: Discussionunclassified

The state of the lumen of the major cerebral vessels and systems of regulation of cerebral circulation in patients with cerebral ischemia with the development of epileptic seizures

et al. 2022

View full text Add to dashboard Cite

Introduction. Cerebrovascular diseases are often associated with the development of epileptic seizures. It was suggested that in the implementation of epileptogenesis in patients with ischemic brain damage, a hemodynamic factor, namely the state of the perfusion reserve, may be important.Objective. The examination of the state of cerebrovascular reactivity of different cerebral vascular basins in patients with the development of epileptic seizures affected by cerebral ischemia.Materials and methods. 772 patients with acute and chronic cerebral ischemia (265 stroke patients with epileptic seizures and 174 patients with seizures on the background of chronic cerebral ischemia and 203 patients with stroke and 130 patients with chronic cerebral ischemia without seizures) was comprehensively examined.Results. In patients with cerebral ischemia, focal seizures prevail. Cortical localization of ischemic foci prevailed in patients with both acute and chronic cerebral ischemia. Stenosis of the main arteries were more often detected as in patients with ischemic stroke with the development of epileptic seizures – 218 (82.3%) compared with patients with stroke in the comparison group – 151 (74.4%) patients, р < 0.05), and in patients with CBI (chronic brain ischemia) with the development of epileptic seizures – 121 (69.5%) people, p < 0.05) compared with patients in the comparison group – 74 (56.9%) patients. The prevalence of stenosisof the main cerebral arteries was revealed in more than 70% in patients with pre-stroke epileptic seizures – 77 (33.5%) compared with patients without precursor seizures, who have been diagnosed with stenosis of more than 70% were found in only 4 (11.5%) patients (χ2 = 10.1; p = 0.03). In the comparison group of patients, there was no significant difference in CVR (cerebrovascular reactivity) changes in the carotid system and in the VBS (vertebrobasilar system) – 30 (36.6%) and 42 (47.7%) examined, respectively.Conclusion. The revealed decrease in cerebrovascular reactivity in the vertebrobasilar basin can be considered as one of the risk factors for the development of epilepsy in conditions of brain ischemia.

show abstract

“…The continuous increase of 4-HNE promotes inflammatory reactions, which enhance free radical production, increase excitability of neurons, and induce epilepsy [14], [15]. Recent studies suggest that inflammatory mediators, such as interleukin IL-1β, IL-6, and IL-10, play a significant role in the underlying pathophysiology of early seizures during stroke [16], [17], [18], [19], [20], [21], [22], [23]. The high level of tumor necrosis factor associated with the inflammatory response after stroke is an important cause of post-stroke epilepsy [24], [25], [26], [27].…”

Section: Laboratory Diagnosticsmentioning

confidence: 99%

Epilepsy in Stroke as De Novo Independent Nosology Unit – Physiology, Pathogenesis, Histology, Clinical Picture, Diagnosis, and Treatment – A Systematic Review

Naydenov¹,

Prakova

Tsokeva

et al. 2023

Open Access Maced J Med Sci

View full text Add to dashboard Cite

INTRODUCTION: Early seizures are considered complications of stroke, and late seizures are a type of structural epilepsy. If they are separated as a new independent nosology unit, the problem in the diagnostic – treatment approach will be solved. PHYSIOLOGY: Cerebral blood flow is regulated by local factors such as carbon dioxide and oxygen content. Brain activity is also an important factor in the regulation of the volume speed of the blood – with locally increased neuronal activity, the local blood flow increases. Neurons in the CNS are subject to a variety of effects mediated by membrane receptors of two types – ionotropic and metabotropic. PATHOGENESIS: Early seizures are due to transient biochemical dysfunctions, while late seizures are due to gliosis changes affecting neuronal excitability. HISTOLOGY: The highlighted histopathological aspects confirm and support the results of clinical and radiological studies with dead nervous tissue, replaced by numerous newly formed capillaries, and surrounded by lipid-laden macrophages. CLINICAL PICTURE: This is represented by a complex combination of excitatory epileptic manifestations and residual focal symptoms depending on the localization of the lesion. LABORATORY DIAGNOSTICS: A very typical group of patients with post-stroke seizures have a high risk of recurrence when some of the studied biomarkers for this are available in the blood. In summary, the additional expanded package of studies of stroke patients should include screening diagnostics for the risk of epileptic seizures, namely: IL-6, IL-1β, TNF, Mg2+, Ca2+, CD40L, and Hsc70. IMAGING: Transient periodic MRI abnormalities have been demonstrated, possibly as a result of cerebral edema induced by seizure activity. Routine MRI in stroke patients is recommended. TREATMENT: It is possible that rt-PA may increase the risk of early seizures after stroke. Levetiracetam (LEV) as a neuroprotective agent in stroke has been proposed as the drug of first choice, based on safety and efficacy profiles. The usual practice is to treat recurrent early-onset seizures with short-term (3–6 months) treatment with antiepileptic drugs. CONCLUSIONS: Separation of stroke-epilepsy as a new independent nosology entity will solve the diagnostic-treatment problems in this area by changing the minimum package for laboratory tests, as well as routine MRI in patients with clinical evidence of stroke. LEV is the first-line agent for the treatment of these patients, in combination with correction of registered laboratory parameters.

show abstract

Advances in the Development of Biomarkers for Poststroke Epilepsy

Cited by 9 publications

References 70 publications

Risk Factors Associated with Epilepsy Related to Cerebrovascular Disease: A Systematic Review and Meta-Analysis

Risk Factors Associated with Epilepsy Related to Cerebrovascular Disease: A Systematic Review and Meta-Analysis

The state of the lumen of the major cerebral vessels and systems of regulation of cerebral circulation in patients with cerebral ischemia with the development of epileptic seizures

Epilepsy in Stroke as De Novo Independent Nosology Unit – Physiology, Pathogenesis, Histology, Clinical Picture, Diagnosis, and Treatment – A Systematic Review

Contact Info

Product

Resources

About