Risk factors for post-stroke seizure recurrence after the first episode

Tomari, Shinya; Tanaka, Tomotaka; Ihara, Masafumi; Matsuki, Takayuki; Fukuma, Kazuki; Matsubara, Soichiro; Nagatsuka, Kazuyuki; Toyoda, Kazunori

doi:10.1016/j.seizure.2017.09.007

Cited by 25 publications

(15 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The stroke-related factors have been more extensively studied than epilepsy-related ones in post-stroke epilepsy, and none of the characteristics of epilepsy have been associated with long-term recurrent seizures in stroke patients. The likelihood of recurrent seizures is thought to be higher after early-onset PSSE than after a single earlyonset post-stroke seizure, although conclusive scientific evidence to support this notion is lacking [15,24]. In an earlier study we found that patients with PSSE lasting > 12 h have a poorer prognosis at short-and long-term [31].…”

Section: Discussionmentioning

confidence: 90%

“…However, few studies have discussed the prognosis or the factors associated with seizure recurrence specifically in patients with PSSE. Tomari et al reported that patients with early post-stroke SE were more likely to experience a remote recurrent seizure than those with a single early post-stroke seizure [24]. Rumbach et al reported a seizure recurrence rate of 61.3% in PSSE, including early and late-onset events [14], whereas Velioglu et al only examined recurrent SE (29.4%) [25].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term epilepsy after early post-stroke status epilepticus

Abraira

Toledo

Guzmán

et al. 2019

Seizure

View full text Add to dashboard Cite

The risk of developing epilepsy at long term after post-stroke status epilepticus (PSSE) is unknown. We aimed to evaluate post-stroke epilepsy (PSE) after early-onset PSSE and its associated factors.Method: All consecutive patients with early-onset PSSE and no history of epilepsy admitted to our hospital between February 2011 and April 2017 were included. We analysed status epilepticus (SE) and stroke-related factors in relation to the development of PSE.Results: Fifty patients with early-onset PSSE were analysed. Mean age was 74.8 ± 14.3 years and 22 (44%) were women. Median NIHSS at the onset of PSSE was 11 (IQR 4-16) and median PSSE duration was 12 h (IQR 4.69-57). Median follow-up was 214 days (IQR 7.5-747). Ten patients (20%) developed PSE at a median delay of 153 days (IQR 20-334). On multivariate analysis, NIHSS > 4 (p = 0.019; hazard ratio: 15.757; 95% CI, 1.564-158.799) and PSSE > 16 h (p = 0.023; hazard ratio: 7.483; 95% CI, 1.325-42.276) were independently associated with a greater risk of PSE. The mean time from PSSE to onset of recurrent seizures was 142 days in patients with PSSE > 16 h and 310 days (IQR 147-480) in PSSE < 16 h (p = 0.094).Conclusions: NIHSS score > 4 at the stroke presentation and PSSE duration > 16 h may predict of PSE in patients with early-onset PSSE. Recurrence may develop earlier in PSSE patients with longer duration of the episode.

show abstract

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Long-term epilepsy after early post-stroke status epilepticus

Abraira

Toledo

Guzmán

et al. 2019

Seizure

View full text Add to dashboard Cite

show abstract

“…Cox proportional hazards modeling was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Potential confounding factors such as sex (Kim et al, 2016), age (Kim et al, 2016;Tanaka et al, 2015;Tomari et al, 2017), and other variables with a p value < .10 between the ASM groups were adjusted in a multivariate model (model…”

Section: Statistical Analysesmentioning

confidence: 99%

Antiseizure medications for post‐stroke epilepsy: A real‐world prospective cohort study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background and purpose:The management of post-stroke epilepsy (PSE) should ideally include prevention of both seizure and adverse effects; however, an optimal antiseizure medications (ASM) regimen has yet been established. The purpose of this study is to assess seizure recurrence, retention, and tolerability of older-generation and newer-generation ASM for PSE. Methods: This prospective multicenter cohort study (PROgnosis of Post-Stroke Epilepsy [PROPOSE] study) was conducted from November 2014 to September 2019 at eight hospitals. A total of 372 patients admitted and treated with ASM at This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

show abstract

“…Although stroke etiology, size, and localization of the lesions were not associated with SE, functional disability (modified Rankin Scale > 3) was found to be a risk factor for SE following stroke [2,3]. While there was no significant differ-Eur Neurol 2018;80:256-260 DOI: 10.1159/000496512 ence in the mortality between post-stroke patients with and without SE, early-onset SE that occurred within 1 week after stroke was associated with a lower survival and higher recurrence rate compared to late-onset SE [2,7]. SE has been classified into convulsive SE (CSE) and nonconvulsive SE (NCSE) [8].…”

Section: Introductionmentioning

confidence: 98%

Risk Factors for Nonconvulsive Status Epilepticus after Stroke

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background: Status epilepticus (SE) sometimes occurs after stroke. SE is classified as convulsive SE (CSE) and nonconvulsive SE (NCSE). Clinical characteristics, outcomes, mortality, and recurrences of post-stroke NCSE are yet to be clarified. Methods: We retrospectively identified post-stroke SE patients between April 2010 and September 2015, with follow-ups continued until March 2016. We compared baseline clinical characteristics (age, sex, past history of epilepsy, early seizure, stroke type, and localization) between the CSE and NCSE groups. We determined the Glasgow Outcome Scale (GOS) at discharge, along with the mortality and seizure recurrence rates for the two groups. Results: We identified 300 consecutive post-stroke seizure patients admitted to our department. A total of 50 post-stroke SE patients (33 men; mean age, 71.6 ± 14.2 years; 38 CSE; 12 NCSE; 20 ischemic strokes; 23 intracerebral hemorrhages; 7 subarachnoid hemorrhages) were included. Multivariable analysis showed that cardioembolic stroke and frontal lesion were significant risk factors of NCSE after stroke. GOS (Scale 1/2/3/4/5) results at patient discharge showed there was no significant difference between the groups (CSE; 8/26.3/18.4/26.3/21%, NCSE; 0/25/33/25/17%). Follow-up in 31 patients (21 CSE, 10 NCSE, median 815 days, interquartile range 538–1,327 days), revealed that seizure recurred in 15 CSE patients (71%) and in 4 NCSE patients (40%). During the follow-up, 3 CSE patients (14%) and 2 NCSE patients (20%) died. Seizure recurrence and mortality were not significantly different between the 2 groups. Conclusion: Cardioembolic stroke and frontal lesion were significant risk factors of NCSE after stroke.

show abstract

Risk factors for post-stroke seizure recurrence after the first episode

Abstract: In patients with post-stroke seizure, status epilepticus and younger age were the predictors of recurrence after early and late seizure, respectively.

Cited by 25 publications

References 36 publications

Long-term epilepsy after early post-stroke status epilepticus

Long-term epilepsy after early post-stroke status epilepticus

Antiseizure medications for post‐stroke epilepsy: A real‐world prospective cohort study

Risk Factors for Nonconvulsive Status Epilepticus after Stroke

Contact Info

Product

Resources

About