No concerns for post-stroke seizure or epilepsy with rTPA; A retrospective cohort study

Abstract

Background: Recombinant tissue plasminogen activator (rTPA) is the gold standard therapy for ischemic stroke patients within the appropriate time interval. In addition to its undoubtedly benefits, recognizing its possible adverse effects is of utmost importance. This study aims to investigate the possible correlation between rTPA administration and the risk of post-stroke epilepsy. Methods: In a retrospective cohort study, we enrolled subjects identified to have an ischemic stroke event without prior history of epilepsy based on their medical records. Then, followed them retrospectively regarding any subsequent seizure or epilepsy syndromes. Results: rTPA therapy showed no correlations with seizures during the first week after stroke or with the epilepsy syndromes. Positive history of prior ischemic stroke, cortical localization of stroke, cardio embolic source of the stroke, and positive hemorrhagic complication were predictors of post-stroke seizure during the first week following the stroke event. Higher final Modified Rankin Scale (MRS) and cortical localization of stroke were predictors of post-stroke epilepsy (PSE). Conclusion rTPA is a safe therapeutic measure for patients with ischemic stroke with no concerns of subsequent development of post-stroke seizure or epilepsy.