Generalized epileptic seizures as the presenting symptom of lacunar infarction in the brain

Avrahami, E; Drory, Vivian E.; Rabey, Martin; Cohn, Dan F.

doi:10.1007/bf00314250

Cited by 27 publications

(12 citation statements)

References 20 publications

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“…In view of the controversial data in the literature [6,8,9], no patients with early-onset seizures are observed in our study. The time of occurrence of seizures in relation to the lacunar stroke(s) is highly variable and, on average, longer than for those in relation to territorial infarcts.…”

Section: Discussioncontrasting

confidence: 75%

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Seizures and epilepsy in patients with lacunar strokes

Reuck

Nagy

Maele

2007

Journal of the Neurological Sciences

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Section: Discussioncontrasting

confidence: 75%

“…While the risk factors for seizures related to territorial infarcts [4,5] are well known, the relation to lacunar infarcts remains uncertain [6][7][8][9]. Fisher [10] even considered his occurrence in a stroke patient as an exclusion criterion for the diagnosis of a lacunar infarct.…”

Section: Introductionmentioning

confidence: 97%

Seizures and epilepsy in patients with lacunar strokes

Reuck

Nagy

Maele

2007

Journal of the Neurological Sciences

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“…Epilepsia após AVC tem sido relacionada mais frequentemente a lesões do território carotídeo, tanto em estudo anatomopatológico 23 como clínico 7,25 . Numa revisão realizada por Shinton et al 25 não foi encontrado relato de epilepsia após AVC em pacientes com lesões restritas ao território vertebrobasilar; lesões profundas, sem comprometimento cortical, como causa de epilepsia, têm sido observadas ocasionalmente 20,25 e infartos lacunares são raramente referidos como etiologia de epilepsia 1,8,27 , sendo que o tamanho do infarto parece ter relação com crises epilépticas 12 . Os nossos achados foram, portanto, concordantes com a literatura, tendo sido o quadro clínico também indicativo de acometimento carotídeo nos pacientes do G1 11 .…”

Section: Discussionunclassified

Exames subsidiários preditivos de crises epilépticas após acidente vascular cerebral isquêmico

Fukujima¹,

Cardeal

1997

Arq. Neuro-Psiquiatr.

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RESUMO -Na tentativa de detectar fatores preditivos para ocorrência de crises epilépticas após acidente vascular cerebral isquêmico (AVCI), estudamos exames laboratoriais de glicemia, hematócrito, colesterol total e frações e triglicérides, além de eletrocardiograma, eletrencefalograma (EEG), líquido cefalorraquiano e tomografia computadorizada do crânio (TC) em 35 pacientes com AVCI que evoluíram com crises epilépticas após pelo menos 24 horas a partir da instalação do AVCI (grupo 1 ou G1), que foram comparados a 35 pacientes com AVCI que evoluíram sem crises epilépticas (grupo 2 ou G2). Encontramos significância na análise EEG na comparação dos grupos, sendo a alteração mais freqüente o alentecimento focai da atividade elétrica cerebral no G1. A presença de lesão extensa na TC também associou-se ao G1. A associação de EEG anormal e lesão extensa na TC pode ser considerado elemento preditivo para ocorrência de crises epilépticas após AVCI com coeficiente de concordância de 34%. Os demais exames estudados não mostraram significância na comparação entre os grupos G1 e G2. PALAVRAS-CHAVE: doença cerebrovascular, infarto cerebral, epilepsia, eletrencefalograma, tomografia. Epileptic seizures after ischemic stroke: are there any preditive laboratory test?ABSTRACT -We studied subsidiary laboratorial tests such as serum glucose, red blood cell count, total cholesterol, HDL and LDL cholesterol and triglycerides, eletrocardiogram, eletroencephalogram (EEG), cerebrospinal fluid, and CT scan of 35 patients with cerebral infarction who developed epileptic seizures (group 1 or G1), and compared them to a group of 35 patients who had cerebral infarction but have not developed epileptic seizures (group 2 or G2). The EEG analysis showed significance in the comparison between the groups; focal lentification of the electrical cerebral activity was the most frequent abnormality found in G1. Extensive infarcts were also more frequent in G1. The association of abnormal EEG and extensive lesion on CT may be considered a preditive factor for occurrence of epileptic seizures after cerebral infarction. The analysis of the other tests showed no significance on the comparison between the groups. KEY WORDS: stroke, cerebral infarction, epilepsy, epileptic seizures, eletroencephalography, tomography.As crises epilépticas constituem importante complicação dos acidentes vasculares cerebrais (AVC), ocorrendo em 3,3 a 4,3% dos AVC na fase aguda, isto é, nos primeiros 14 dias desde sua instalação, e em 3 a 19% dos AVC na fase tardia, ou seja, após 14 dias da sua instalação 9,17,19,20,23,25 . Há dois principais mecanismos fisiopatológicos para explicar a ocorrência de crises epilépticas relacionadas ao AVC. As crises da fase aguda ocorreriam devido a alterações metabólicas citotóxicas conseqüentes à lesão cerebral, que poderiam induzir crises epilépticas por si só, ou poderiam ocorrer Este estudo faz parte da Tese de Mestrado "Crises epilépticas após acidente vascular cerebral por infarto cerebral: estudo de 35 pacientes" 10 , aprovada no Curso

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“…The authors observed seizures in 18% of their 47 neuropathologically verified cases. In a more recent study of patients with MRI features of subcortical vascular en cephalopathy, subcortical lacunar lesions appeared to be associated with a significant risk for seizures [ 18], Rarely, lacunar infarctions may be associated with generalized tonic-clonic seizures [19]. In a systematic analysis of 118 patients with postthrombotic ischemia-related seizures, 5 patients (4.2%) presented with lacunar infarction on the CT; 4 out of those developed chronic epilepsy [20].…”

Section: Subcortical Infarctionmentioning

confidence: 99%

Stroke and Epilepsy: Critical Review of the Literature

Pohlmann‐Eden¹,

Cochius

Hoch

et al. 1997

Cerebrovasc Dis

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Many questions regarding the mechanisms underlying the development of seizures in cerebral stroke remain unanswered. However, the continued critical investigation of this important issue is likely to ultimately lead to a better understanding of early focal hyperexcitability after stroke and late epileptogenesis. Part II of this critical review continues to identify risk factors for seizures after stroke focussing on ischemic conditions with special regard to stroke distribution, predictive EEG patterns, pathophysiology and the somewhat confusing ''overlap syndromes'' that may involve both vascular and ictal phenomena.

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Generalized epileptic seizures as the presenting symptom of lacunar infarction in the brain

Cited by 27 publications

References 20 publications

Seizures and epilepsy in patients with lacunar strokes

Seizures and epilepsy in patients with lacunar strokes

Exames subsidiários preditivos de crises epilépticas após acidente vascular cerebral isquêmico

Stroke and Epilepsy: Critical Review of the Literature

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