Risk Factors for Developing Seizures After a Stroke

Abstract

We evaluated development of seizures in 219 consecutive patients who had ischemic or hemorrhagic stroke. Subjects with transitory ischemic attacks, subarachnoid, subdural, and epidural hemorrhages or those with previous history of epilepsy were excluded. Mean follow-up time was 11.5 months (range 1-72 months). Twenty-two of 219 stroke patients (10.04%) had seizures. Twelve (54.55%) were of early onset (< 1 month after the stroke), and 10 (45.45%) were of late onset. No statistically significant differences were evident between the early- and late-onset seizure group in comparisons of type of stroke, localization, and size of the lesion. Six of 22 patients (27%) had seizure recurrence. Seizures developed in (a) 13 of 183 patients with ischemic stroke (7.1%) and 9 of 36 patients with hemorrhagic stroke (25%) (p = 0.01); (b) 16 of 93 patients with cortical lesions (17%) and 6 of 126 patients with subcortical lesions (4.7%) (p = 0.01); and (c) 14 of 66 patients with a lesion comprising more than one lobe (21.2%) and 8 of 153 patients with a lesion comprising less than one lobe (5.2%) (p < 0.01). We conclude that patients with hemorrhagic stroke, cortical lesions, and lesions involving more than one lobe are at higher risk of developing seizures.

Doença cerebrovascular na infância: I. Manifestações epilépticas

“…A Tabela 4 mostra a frequência de AVCI e AVCH nos grupos 1 e 2 nos quais, ao contrário do que é habitualmente encontrado na literatura 10 , se evidencia predomínio de AVCI em relação a AVCH nos pacientes com manifestações epilépticas associadas a DCV. A comparação entre AVCI e AVCH nos 2 grupos não apresentou diferença estatisticamente significante (p=0,2042 para AVCI; p=0,4850 para AVCH e p=0,6121 para AVCI-AVCH).…”

“…A Tabela 5 mostra a distribuição da localização da DCV nos grupos 1 e 2, nos quais o envolvimento cortical evidenciado pela neuroimagem é fator estatisticamente significante (p=0,0101) na ocorrência de manifestação epiléptica associada à DCV, o que está de acordo com os achados da literatura [4][5][6]10 . Apesar de menos frequente, a manifestação epiléptica pode estar associada a DCV subcortical, algumas vezes porque uma lesão cortical adjacente não foi demonstrada na tomografia de crânio, ou ainda porque a lesão, como por exemplo na cabeça do núcleo caudado, pode apresentar atividade epileptiforme 7,11 .…”

Correlation between Lesion Location and EEG Findings in Post-stroke Epilepsy

“…Bazı kaynaklar inme sonrası dördüncü haftaya kadar olan nöbetleri erken nöbet olarak kabul etmektedir. [8][9][10] Bizim çalışmamızda, inme sonrası ilk 15 gün gelişen nöbetler erken başlangıçlı, 16 gün ve sonrasında gelişen nöbetler ise geç başlangıçlı olarak değerlendirilmiştir. Berges ve ark.nın [11] inme sonrası epilepsi olgularını "erken ve geç" olarak iki kategoride incelemeyi öneren, inmeden sonra ilk 15 gün içinde görülen nöbeti erken olarak kabul eden, 159 hastayı içeren çalışmasında; erken nöbet görülme oranı %35, Demir ve ark.…”

Seizures and Strokes for Certain Folks

“…Seizures that emerge as a late consequence of acute stroke are presumably the result of epileptogenic changes resulting from strokerelated brain injury. Factors that increase risk for post-stroke seizures include intracerebral hemorrhage, hemorrhagic conversion after ischemic infarction, cortical involvement, and stroke size (3,4). However, the incidence and prognostic implications of early seizures have not been fully defined.…”