The incidence rate of post-stroke epilepsy: A 5-year follow-up study in Taiwan

Chen, Ta-Cheng; Chen, Yen‐Yu; Cheng, Pei-Yu; Lai, Chao-Hung

doi:10.1016/j.eplepsyres.2012.06.003

Cited by 40 publications

(31 citation statements)

References 31 publications

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“…It was conceptualized by John Hughlings Jackson in 1864 and William Gowers in 1885, the latter having reported on 66 cases of what he called ''post-hemiplegic epilepsy''. Since the work of these pioneers, several epidemiological studies have shown that stroke was the leading cause of epilepsy beginning after the age of 60 years (Chen et al, 2012;Menon and Shorvon, 2009). Inline with the study of Ogunniyi et al (1987) we have not found significant differences between the two groups with regard to cerebrovascular disease.…”

Section: Discussionmentioning

confidence: 73%

Consanguinity and epilepsy in Oran, Algeria: A case–control study

et al. 2015

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Section: Discussionmentioning

confidence: 73%

Consanguinity and epilepsy in Oran, Algeria: A case–control study

et al. 2015

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“…According to the data of Afsar et al, 26 posterior cerebral artery infarcts are more prevalent in adults affected by late post-stroke seizures than in adults affected by early post-stroke seizures. In contrast, Chen et al, 27 who studied an adult population in Taiwan, reported that the risk of post-stroke epilepsy is higher after haemorrhagic stroke than ischaemic stroke. In our study, infection was observed in 29% of participants suffering from late post-stroke seizures.…”

Section: Discussionmentioning

confidence: 88%

Post‐stroke epilepsy in Polish paediatric patients

Kopyta

Sarecka-Hujar

Skrzypek

2015

Develop Med Child Neuro

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AISArterial ischaemic stroke FCA Focal cerebral arteriopathy LACI Lacunar anterior circulation infarct PACI Partial anterior circulation infarct POCI Posterior circulation infarct TACI Total anterior circulation infarct AIM The aim of this study was to characterize a group of children with early and late remote seizures, which occurred after arterial ischaemic stroke (AIS), and to find predictors of poststroke seizures.METHOD The study group, recruited in the Department of Neuropediatrics (Medical University of Silesia, Katowice, Poland), comprised 78 individuals (range 1-18y) who had suffered a stroke: 13 participants had early seizures, occurring up to 7 days after AIS, seven participants had late remote seizures, occurring more than 7 days after AIS, and 58 participants had no seizures.RESULTS Post-stroke epilepsy occurred in 10 patients having post-stroke seizures. Participants affected by late remote seizures were younger, on average, than participants unaffected by seizures. The frequencies of total anterior circulation infarct (TACI) stroke subtype and focal cerebral arteriopathy (FCA) were significantly higher in the late seizure subgroup than in the subgroup without seizures (71% vs 26%, p=0.014, OR 7.17, and 100% vs 51%, p=0.015 respectively). Multivariable Cox analysis showed that age at time of stroke (p=0.027), FCA (p=0.010), and the number of infarct foci (p<0.001) were significant predictors of post-stroke seizures.INTERPRETATION Age at time of stroke, presence of FCA, and number of infarct foci are predictors of post-stroke seizures in Polish paediatric patients.Seizures are a major complication that can occur after ischaemic stroke and, later, the development of epilepsy is a serious threat. In adults, stroke is considered a risk factor for status epilepticus. 1 Seizures are also associated with other cerebrovascular lesions, such as intracranial haemorrhage and subarachnoid haemorrhage. It has been reported that the prevalence of post-stroke epilepsy in adult stroke patients varies from 2% to 4%.2 Another study reported a prevalence of post-stroke epilepsy of 3% to 5% in stroke survivors. 3 The risk of developing post-stroke epilepsy increases further after a second ischaemic incident. Seizures are a consequence of stroke more often in children than in adults; it has been reported that the incidence of seizures within 24 hours of a stroke is 18 times higher in children than in adults. Arterial ischaemic stroke (AIS) in children is a rare disorder, occurring in approximately 3 per 100 000 children per year. A history of acute brain ischaemia is related to various neurological complications, such as motor impairment (hemiparesis is observed most commonly), speech impairment, and intellectual delay. 5 According to several studies concerning seizures and epilepsy occurring after AIS in children, the incidence of these complications is quite high.6,7 Lee et al. 6 observed seizures in 37%, and epilepsy in 20%, of children who had suffered a stroke. In a group of children from Hong Kong affected by is...

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“…5–9, 18, 19 A recent study of perinatal and childhood intracerebral hemorrhage found 13% of children developed epilepsy by two years. Several large population-based studies of post-stroke seizures in adults have used survival analysis techniques; in spite of varying definitions of late seizures and post-stroke epilepsy, the range of 3–5% cumulative incidence by five years 2010112122, 23 is relatively consistent (Table 3). While different definitions across studies might influence incidence rates, all of the comparable definitions result in lower estimates in the adult studies, suggesting that the developing brain may be more susceptible than the mature brain to remote seizures and epilepsy after an injury.…”

Section: Discussionmentioning

confidence: 99%

Acute seizures predict epilepsy after childhood stroke

Fox

Glass

Sidney

et al. 2013

Annals of Neurology

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Objective To determine incidence rates and predictors of epilepsy after childhood stroke and compare these to published estimates of 3–5% cumulative epilepsy incidence by five years post-stroke in adults. Methods In a retrospective population-based study of children with stroke (29 days−19 years) in an integrated health care system (1993–2007), post-stroke seizures were identified through electronic searches and confirmed by chart review. Stroke and seizure characteristics were abstracted from medical records. Survival analysis was used to determine rates and predictors of remote seizures and active epilepsy (anti-convulsant treatment for remote seizure within prior 6 months) at last follow-up. Results From a population of 2.5 million children, we identified 305 stroke cases. Over a median follow-up of 4.1 years (interquartile range 1.8–6.8), 49 children had a first unprovoked remote seizure. The average annual incidence rate of first remote seizure was 4.4% (95% confidence interval [CI] 3.3, 5.8) with a cumulative risk of 16% (CI 12%, 21%) at 5 years and 33% (CI 23%, 46%) at 10 years post-stroke. The cumulative risk of active epilepsy was 13% (CI 9%, 18%) at five years and 30% (CI 20%, 44%) at 10 years. Acute seizures at the time of stroke predicted development of active epilepsy (hazard ratio [HR] 4.2, CI 2.2, 8.1). At last follow-up, one-third of the children with active epilepsy had a recent breakthrough seizure despite anti-convulsant usage. Interpretation Unlike adults, children are uniquely vulnerable to epilepsy after stroke. Children with acute seizures at the time of stroke are at particularly high risk.

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The incidence rate of post-stroke epilepsy: A 5-year follow-up study in Taiwan

Cited by 40 publications

References 31 publications

Consanguinity and epilepsy in Oran, Algeria: A case–control study

Consanguinity and epilepsy in Oran, Algeria: A case–control study

Post‐stroke epilepsy in Polish paediatric patients

Acute seizures predict epilepsy after childhood stroke

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