Investigation of poststroke epilepsy (INPOSE) study: a multicenter prospective study for prediction of poststroke epilepsy

Yamada, Shuichi; Nakagawa, Ichiro; Tamura, Kentaro; Nishimura, Fusanori; Motoyama, Yasushi; Park, Young Soo; Nakase, Hiroyuki

doi:10.1007/s00415-020-09982-2

Cited by 16 publications

(23 citation statements)

References 21 publications

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“…Although we observed a significant association between recurrent stroke and PSE in this study, our results failed to indicate that smoking and heavy drinking were independent risk factors for PSE. This is also consistent with some previous studies on the young population ( 9 , 24 , 27 ).…”

Section: Discussionsupporting

confidence: 93%

“…Several predictive factors for PSE were determined through the 16-year follow-up among patients aged 19–44 years after ischemic stroke, including seizure at first admission of stroke, aphasia, severity of stroke (high NIHSS score and prolonged hospital stay), recurrent stroke, and drug abuse. The incidence of PSE following ischemic stroke was 6.2%, consistent with the rate of 2.7%−6.6% in previous studies ( 10 , 12 , 13 , 24 ). Our results also revealed that PSE more frequently occurred in younger patients ( p = 0.001).…”

Section: Discussionsupporting

confidence: 90%

“…Evidence demonstrated an increased risk of PSE in stroke patients with hypertension, hyperlipidemia, or diabetes ( 23 ). By contrast, no correlation was found in another study ( 24 ). Some unhealthy behaviors such as smoking, drinking, and drug abuse have emerged as risk factors for the onset and recurrence of stroke in young adults in modern life ( 25 , 26 ).…”

Section: Introductionmentioning

confidence: 67%

“…Similarly, some studies also suggested that hyperlipidemia was more prevalent in the non-PSE group than in the PSE group ( 11 , 49 , 50 ). Yamada et al reported that none single of the comorbidities, including hypertension, hyperlipidemia, diabetes, and coronary disease, conferred a significant correlation with PSE but the presence of more than one underlying disease was associated with a significantly lower probability of developing PSE ( 24 ). The lower incidence of PSE in stroke patients with dyslipidemia can be explained by the seizure-protective effects of lipid-lowering agents, statin used for this condition.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Postischemic Stroke Epilepsy in Young Adults: A Nationwide Population-Based Study in Taiwan

et al. 2022

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BackgroundThe incidence of ischemic stroke has been increasing in the young population over the past 20 years. Poststroke epilepsy (PSE) is a common complication after stroke. However, few population-based studies with sufficient follow-up have investigated factors associated with PSE, especially factors related to comorbidities and unhealthy lifestyles in the modern young population. Accordingly, this study aimed to determine the long-term incidence and these risk factors for PSE young adults.MethodsThis cohort study was conducted using data from the Taiwan National Health Insurance Research Database (NHIRD) from 2002 to 2018. All patients aged between 19 and 44 years and diagnosed with ischemic stroke from 2002 to 2015 were retrospectively enrolled with a follow-up of at least 3 years. Multivariable Cox regression models were performed to identify predictors of PSE, including patients' demographics, baseline conditions, stroke severity, etiologies, comorbidities, and unhealthy behaviors.ResultsAmong 6,512 ischemic stroke patients, 402 cases (6.2%) developed PSE who were with a mean follow-up period of 8.3 years (SD = 4.3 years). During the overall follow-up, stroke severity and manifestations were associated with PSE, including National Institutes of Health Stroke Scale (NIHSS) score ≥10 (aHR, 1.98; 95% CI, 1.50–2.61), seizure at first stroke admission [adjusted hazard ratio (aHR), 57.39; 95% confidence interval (CI), 43.02–76.55], length of hospital stay ≥14 days (aHR, 1.60; 95% CI, 1.26–2.02), recurrent stroke (aHR, 2.32; 95% CI, 1.85–2.90), aphasia (aHR, 1.77; 95% CI, 1.20–2.60), and malignancy (aHR, 2.05; 95% CI, 1.30–3.24). Furthermore, stroke patients with drug abuse were 2.90 times more likely to develop PSE than those without (aHR, 2.90; 95% CI, 1.53–5.50). By contrast, statin use (aHR, 0.62; 95% CI, 0.48–0.80) was associated with a lower risk of PSE. The risk factors at 1-year and 5-year PSE were similar to that of an overall follow-up.ConclusionsStroke severity, aphasia, malignancy, and drug abuse were associated increased risk of PSE and statin use may protect against PSE in young adults. Reducing the severity of stroke, statin use and controlling unhealthy behaviors might be able to decrease the development of PSE. Since PSE is associated with poor outcomes, early identification or intervention of PSE based on the risk factors might reduce the harmful effects of PSE.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Postischemic Stroke Epilepsy in Young Adults: A Nationwide Population-Based Study in Taiwan

et al. 2022

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“…One pediatric study reported that stroke location was unrelated to the occurrence of seizures ( López-Espejo et al, 2018 ). Another study provided evidence that PSS was more likely in cases where stroke occurred in the frontal lobe ( Yamada et al, 2020 ). Overall, the link between stroke location and the occurrence of PSS remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Strategic infarct location for post-stroke seizure

Chou

Shih

Chiu

et al. 2022

NeuroImage: Clinical

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Development and validation of a novel radiomics-clinical model for predicting post-stroke epilepsy after first-ever intracerebral haemorrhage

Lin

et al. 2023

Eur Radiol

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Investigation of poststroke epilepsy (INPOSE) study: a multicenter prospective study for prediction of poststroke epilepsy

Cited by 16 publications

References 21 publications

Risk Factors for Postischemic Stroke Epilepsy in Young Adults: A Nationwide Population-Based Study in Taiwan

Risk Factors for Postischemic Stroke Epilepsy in Young Adults: A Nationwide Population-Based Study in Taiwan

Strategic infarct location for post-stroke seizure

Development and validation of a novel radiomics-clinical model for predicting post-stroke epilepsy after first-ever intracerebral haemorrhage

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