Status Epilepticus in Stroke Patients

Abstract

Background: Status epilepticus (SE) is a life-threatening condition that occurs in only 1.5% of the overall stroke population but in more than 10% of patients with stroke-related seizures. This retrospective study compares the characteristics of stroke patients with SE to those with ordinary seizures (OS). Patients and Methods: The demographic features, vascular risk factors, stroke type and etiology, stroke severity (according to the National Institute of Health Stroke scale) and disability (according to the modified Rankin scale), seizure type and onset, and post-ictal EEG findings were compared between 33 patients with SE and 288 with OS. SE was defined as a >30 min of either continuous seizure activity or multiple seizures without regaining consciousness. Results: Patients with SE had more severe strokes and a worse outcome. Demographic features and stroke etiology were similar in both groups. Chronic obstructive pulmonary disease was only observed as a risk factor in patients with OS. There was a non-statistical trend that SE occurred more frequently at stroke onset. Seizure recurrence was the same in both groups. Post-ictal EEG was always abnormal in the SE patients and normal in 30% of the OS group. Conclusions: SE occurs mainly in patients with a severe stroke and with severe disability. Patients with a severe stroke are probably more at risk of early-onset SE.

Nonconvulsive Status Epilepticus During Perioperative Period of Cerebrovascular Surgery

“…9,25,30) The incidence of convulsive status epilepticus in the population with cerebrovascular disease (CVD) remains unclear, but is estimated at 14-30%. 8,22,28,32) In contrast, the incidence of NCSE in patients with CVD is relatively unstudied. 18,23) The diagnosis of NCSE requires clinical suspicion and EEG confirmation.…”

Early post-acute stroke seizures: Clinical profile and outcome in a Nigerian stroke unit

“…Severe strokes have, however, been found to be more associated with non-convulsive electrographic seizures in related studies. [21] It bears reiteration that in this study convulsive seizures were only clinically assessed, which may explain the absence of any association between stroke severity and EPASS.…”

Risk Factors for Nonconvulsive Status Epilepticus after Stroke

“…Previous studies have reported that functional disability [2], stroke severity [15], and intracerebral hemorrhage [16] were associated with SE after stroke and acute ischemic stroke [17], especially for large atherothrombotic etiology with NCSE [14]. Since cardioembolic stroke tends to involve the cortex, this increases the chances of SE.…”