Epilepsy in cerebrovascular diseases: Review of experimental and clinical data with meta-analysis of risk factors

Edoardo Ferlazzo, Sara Gasparini, Ettore Beghi, Chiara Sueri, Emilio Russo, Antonio Leo, Angelo Labate, Antonio Gambardella, Vincenzo Belcastro, Pasquale Striano, Maurizio Paciaroni, Laura Rosa Pisani, Umberto Aguglia, Epilepsy Study Group of the Italian Neurological Society, Roberto Michelucci, Paolo Tinuper

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Seizures may occur in close temporal association with a stroke or after a variable interval. Moreover, epilepsy is often encountered in patients with leukoaraiosis. Although early post-stroke seizures have been studied extensively, less attention has been paid to post-stroke epilepsy (PSE) and to epilepsy associated with leukoaraiosis (EAL). The aim of this paper is to review data concerning pathophysiology, prognosis, and treatment of PSE and EAL.

METHODS: We performed an extensive literature search to identify experimental and clinical articles on PSE and EAL. We also conducted a systematic review of risk factors for PSE and EAL among eligible studies.

RESULTS: PSE is caused by enhanced neuronal excitability within and near the scar. The role played by white matter changes in EAL remains to be elucidated. Meta-analysis showed that cortical involvement (odds ratio [OR] 3.71, 95% confidence interval [CI] 2.34-5.90, p < 0.001), cerebral hemorrhage (OR 2.41, 95% CI 1.57-3.70, p < 0.001), and early seizures (OR 4.43, 95% CI 2.36-8.32, p < 0.001) are associated with an increased risk of PSE. As regards EAL, no prospective, population-based studies evaluated the role of different variables on seizure risk. Studies about the management of PSE are limited. PSE is generally well controlled by drugs. Data about risk factors, prognosis, and treatment of EAL are lacking.

SIGNIFICANCE: Pathophysiology and risk factors are well defined for PSE but need to be elucidated for EAL. Management of PSE and EAL relies on the clinician's judgment and should be tailored on an individual basis.

Original languageEnglish
Pages (from-to)1205-14
Number of pages10
JournalEpilepsia
Volume57
Issue number8
DOIs
Publication statusPublished - Aug 2016

Fingerprint

Cerebrovascular Disorders
Meta-Analysis
Epilepsy
Leukoaraiosis
Stroke
Seizures
Odds Ratio
Confidence Intervals

Keywords

  • Journal Article
  • Review

Cite this

Epilepsy in cerebrovascular diseases : Review of experimental and clinical data with meta-analysis of risk factors. / Ferlazzo, Edoardo; Gasparini, Sara; Beghi, Ettore; Sueri, Chiara; Russo, Emilio; Leo, Antonio; Labate, Angelo; Gambardella, Antonio; Belcastro, Vincenzo; Striano, Pasquale; Paciaroni, Maurizio; Pisani, Laura Rosa; Aguglia, Umberto; Epilepsy Study Group of the Italian Neurological Society ; Michelucci, Roberto; Tinuper, Paolo.

In: Epilepsia, Vol. 57, No. 8, 08.2016, p. 1205-14.

Research output: Contribution to journalArticle

Ferlazzo, E, Gasparini, S, Beghi, E, Sueri, C, Russo, E, Leo, A, Labate, A, Gambardella, A, Belcastro, V, Striano, P, Paciaroni, M, Pisani, LR, Aguglia, U, Epilepsy Study Group of the Italian Neurological Society, Michelucci, R & Tinuper, P 2016, 'Epilepsy in cerebrovascular diseases: Review of experimental and clinical data with meta-analysis of risk factors', Epilepsia, vol. 57, no. 8, pp. 1205-14. https://doi.org/10.1111/epi.13448
Ferlazzo, Edoardo ; Gasparini, Sara ; Beghi, Ettore ; Sueri, Chiara ; Russo, Emilio ; Leo, Antonio ; Labate, Angelo ; Gambardella, Antonio ; Belcastro, Vincenzo ; Striano, Pasquale ; Paciaroni, Maurizio ; Pisani, Laura Rosa ; Aguglia, Umberto ; Epilepsy Study Group of the Italian Neurological Society ; Michelucci, Roberto ; Tinuper, Paolo. / Epilepsy in cerebrovascular diseases : Review of experimental and clinical data with meta-analysis of risk factors. In: Epilepsia. 2016 ; Vol. 57, No. 8. pp. 1205-14.
@article{5eeeeaf9852940b0bcda2e7746a623a7,
title = "Epilepsy in cerebrovascular diseases: Review of experimental and clinical data with meta-analysis of risk factors",
abstract = "OBJECTIVE: Seizures may occur in close temporal association with a stroke or after a variable interval. Moreover, epilepsy is often encountered in patients with leukoaraiosis. Although early post-stroke seizures have been studied extensively, less attention has been paid to post-stroke epilepsy (PSE) and to epilepsy associated with leukoaraiosis (EAL). The aim of this paper is to review data concerning pathophysiology, prognosis, and treatment of PSE and EAL.METHODS: We performed an extensive literature search to identify experimental and clinical articles on PSE and EAL. We also conducted a systematic review of risk factors for PSE and EAL among eligible studies.RESULTS: PSE is caused by enhanced neuronal excitability within and near the scar. The role played by white matter changes in EAL remains to be elucidated. Meta-analysis showed that cortical involvement (odds ratio [OR] 3.71, 95{\%} confidence interval [CI] 2.34-5.90, p < 0.001), cerebral hemorrhage (OR 2.41, 95{\%} CI 1.57-3.70, p < 0.001), and early seizures (OR 4.43, 95{\%} CI 2.36-8.32, p < 0.001) are associated with an increased risk of PSE. As regards EAL, no prospective, population-based studies evaluated the role of different variables on seizure risk. Studies about the management of PSE are limited. PSE is generally well controlled by drugs. Data about risk factors, prognosis, and treatment of EAL are lacking.SIGNIFICANCE: Pathophysiology and risk factors are well defined for PSE but need to be elucidated for EAL. Management of PSE and EAL relies on the clinician's judgment and should be tailored on an individual basis.",
keywords = "Journal Article, Review",
author = "Edoardo Ferlazzo and Sara Gasparini and Ettore Beghi and Chiara Sueri and Emilio Russo and Antonio Leo and Angelo Labate and Antonio Gambardella and Vincenzo Belcastro and Pasquale Striano and Maurizio Paciaroni and Pisani, {Laura Rosa} and Umberto Aguglia and {Epilepsy Study Group of the Italian Neurological Society} and Roberto Michelucci and Paolo Tinuper",
note = "Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Universit{\`a} di Bologna (Tinuper Paolo)",
year = "2016",
month = "8",
doi = "10.1111/epi.13448",
language = "English",
volume = "57",
pages = "1205--14",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Blackwell Publishing Inc.",
number = "8",

}

TY - JOUR

T1 - Epilepsy in cerebrovascular diseases

T2 - Review of experimental and clinical data with meta-analysis of risk factors

AU - Ferlazzo, Edoardo

AU - Gasparini, Sara

AU - Beghi, Ettore

AU - Sueri, Chiara

AU - Russo, Emilio

AU - Leo, Antonio

AU - Labate, Angelo

AU - Gambardella, Antonio

AU - Belcastro, Vincenzo

AU - Striano, Pasquale

AU - Paciaroni, Maurizio

AU - Pisani, Laura Rosa

AU - Aguglia, Umberto

AU - Epilepsy Study Group of the Italian Neurological Society

AU - Michelucci, Roberto

AU - Tinuper, Paolo

N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Tinuper Paolo)

PY - 2016/8

Y1 - 2016/8

N2 - OBJECTIVE: Seizures may occur in close temporal association with a stroke or after a variable interval. Moreover, epilepsy is often encountered in patients with leukoaraiosis. Although early post-stroke seizures have been studied extensively, less attention has been paid to post-stroke epilepsy (PSE) and to epilepsy associated with leukoaraiosis (EAL). The aim of this paper is to review data concerning pathophysiology, prognosis, and treatment of PSE and EAL.METHODS: We performed an extensive literature search to identify experimental and clinical articles on PSE and EAL. We also conducted a systematic review of risk factors for PSE and EAL among eligible studies.RESULTS: PSE is caused by enhanced neuronal excitability within and near the scar. The role played by white matter changes in EAL remains to be elucidated. Meta-analysis showed that cortical involvement (odds ratio [OR] 3.71, 95% confidence interval [CI] 2.34-5.90, p < 0.001), cerebral hemorrhage (OR 2.41, 95% CI 1.57-3.70, p < 0.001), and early seizures (OR 4.43, 95% CI 2.36-8.32, p < 0.001) are associated with an increased risk of PSE. As regards EAL, no prospective, population-based studies evaluated the role of different variables on seizure risk. Studies about the management of PSE are limited. PSE is generally well controlled by drugs. Data about risk factors, prognosis, and treatment of EAL are lacking.SIGNIFICANCE: Pathophysiology and risk factors are well defined for PSE but need to be elucidated for EAL. Management of PSE and EAL relies on the clinician's judgment and should be tailored on an individual basis.

AB - OBJECTIVE: Seizures may occur in close temporal association with a stroke or after a variable interval. Moreover, epilepsy is often encountered in patients with leukoaraiosis. Although early post-stroke seizures have been studied extensively, less attention has been paid to post-stroke epilepsy (PSE) and to epilepsy associated with leukoaraiosis (EAL). The aim of this paper is to review data concerning pathophysiology, prognosis, and treatment of PSE and EAL.METHODS: We performed an extensive literature search to identify experimental and clinical articles on PSE and EAL. We also conducted a systematic review of risk factors for PSE and EAL among eligible studies.RESULTS: PSE is caused by enhanced neuronal excitability within and near the scar. The role played by white matter changes in EAL remains to be elucidated. Meta-analysis showed that cortical involvement (odds ratio [OR] 3.71, 95% confidence interval [CI] 2.34-5.90, p < 0.001), cerebral hemorrhage (OR 2.41, 95% CI 1.57-3.70, p < 0.001), and early seizures (OR 4.43, 95% CI 2.36-8.32, p < 0.001) are associated with an increased risk of PSE. As regards EAL, no prospective, population-based studies evaluated the role of different variables on seizure risk. Studies about the management of PSE are limited. PSE is generally well controlled by drugs. Data about risk factors, prognosis, and treatment of EAL are lacking.SIGNIFICANCE: Pathophysiology and risk factors are well defined for PSE but need to be elucidated for EAL. Management of PSE and EAL relies on the clinician's judgment and should be tailored on an individual basis.

KW - Journal Article

KW - Review

U2 - 10.1111/epi.13448

DO - 10.1111/epi.13448

M3 - Article

C2 - 27381481

VL - 57

SP - 1205

EP - 1214

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 8

ER -