Prevalence and predictors of post-stroke epilepsy among Ghanaian stroke survivors

Akassi, John; Obese, Vida; Adamu, Sheila; Agbenorku, Manolo; Ovbiagele, Bruce

doi:10.1016/j.jns.2020.117138

Cited by 20 publications

(17 citation statements)

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“…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. Previous investigations have indicated that administering statins can decrease poststroke seizure occurrence and PSE ( 49 , 51 , 52 ). Therefore, we further evaluated the association between PSE and statin treatment in this study.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…The prevalence of early (≤7 days of stroke onset) post-stroke seizures were 9.3% 198 , 9.6% 199 and 13% 200 in the three studies that recorded this data. The prevalence of epilepsy among survivors of stroke in Africa was 1.98–16.9% 201 – 204 (Table 3 ). Factors associated with an increased risk of post-stroke epilepsy included male sex, cortical infarcts and poor access to neurological services.…”

Section: Stroke Phenotypes In Africamentioning

confidence: 99%

Stroke in Africa: profile, progress, prospects and priorities

et al. 2021

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Stroke is a leading cause of disability, dementia and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disability occur in low-income and middle-income countries. At the turn of the century, the most common diseases in Africa were communicable diseases, whereas non-communicable diseases, including stroke, were considered rare, particularly in sub-Saharan Africa. However, evidence indicates that, today, Africa could have up to 2–3-fold greater rates of stroke incidence and higher stroke prevalence than western Europe and the USA. In Africa, data published within the past decade show that stroke has an annual incidence rate of up to 316 per 100,000, a prevalence of up to 1,460 per 100,000 and a 3-year fatality rate greater than 80%. Moreover, many Africans have a stroke within the fourth to sixth decades of life, with serious implications for the individual, their family and society. This age profile is particularly important as strokes in younger people tend to result in a greater loss of self-worth and socioeconomic productivity than in older individuals. Emerging insights from research into stroke epidemiology, genetics, prevention, care and outcomes offer great prospects for tackling the growing burden of stroke on the continent. In this article, we review the unique profile of stroke in Africa and summarize current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care and awareness. We also discuss knowledge gaps, emerging priorities and future directions of stroke medicine for the more than 1 billion people who live in Africa.

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“…As discussed in (6), where FM is feature maps, J denotes input, C indicates convolution filters, c j is column indices of j filters, n denotes feature maps number, and i 1 indicates feature maps columns.…”

Section: Stage 2: Convolutional Neural Network (Cnn)mentioning

confidence: 99%

“…In addition to therapy, physical, cognitive, and mental rehabilitation is offered. However, determining the next therapy step requires regular monitoring and assessment [ 6 ]. Small blood veins in the brain, especially the cerebral vessels, are affected by this disorder, which reduces blood flow.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Gene Mutation Analysis of Poststroke Epilepsy

Shen

Deng

Chun-yan

et al. 2022

Contrast Media & Molecular Imaging

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Epilepsy is one of the most common brain disorders worldwide. Poststroke epilepsy (PSE) affects functional retrieval after stroke and brings considerable social values. A stroke occurs when the blood circulation to the brain fails, causing speech difficulties, memory loss, and paralysis. An electroencephalogram (EEG) is a tool that may detect anomalies in brain electrical activity, including those induced by a stroke. Using EEG data to determine the electrical action in the brains of stroke patients is an effort to measure therapy. Hence in this paper, deep learning assisted gene mutation analysis (DL-GMA) was utilized for classifying poststroke epilepsy in patients. This study suggested a model categorizing poststroke patients based on EEG signals that utilized wavelet, long short-term memory (LSTM), and convolutional neural networks (CNN). Gene mutation analysis can help determine the cause of an individual’s epilepsy, leading to an accurate diagnosis and the best probable medical management. The test outcomes show the viability of noninvasive approaches that quickly evaluate brain waves to monitor and detect daily stroke diseases. The simulation outcomes demonstrate that the proposed GL-GMA achieves a high accuracy ratio of 98.3%, a prediction ratio of 97.8%, a precision ratio of 96.5%, and a recall ratio of 95.6% and decreases the error rate 10.3% compared to other existing methods.

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Prevalence and predictors of post-stroke epilepsy among Ghanaian stroke survivors

Cited by 20 publications

References 50 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

Stroke in Africa: profile, progress, prospects and priorities

Clinical Characteristics and Gene Mutation Analysis of Poststroke Epilepsy

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