TY - JOUR
T1 - Incidence and predictors of acute symptomatic seizures after stroke
AU - Beghi, E.
AU - D'Alessandro, R.
AU - Beretta, S.
AU - Consoli, D.
AU - Crespi, V.
AU - Delaj, L.
AU - Gandolfo, C.
AU - Greco, G.
AU - Neve, A. La
AU - Manfredi, M.
AU - Mattana, F.
AU - Musolino, R.
AU - Provinciali, L.
AU - Santangelo, M.
AU - Specchio, L. M.
AU - Zaccara, G.
PY - 2011/11/15
Y1 - 2011/11/15
N2 - Objective: To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke. Methods: Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors. Results: A total of 714 patients (315 women, 399 men; age 27-97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5-14.9) followed by CIHT (OR 2.7; 95% CI 0.8-9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8-20.8) and for CI (OR 3.1; 95% CI 1.3-7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03-0.8) was a protective factor for IPH. Conclusion: The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke.
AB - Objective: To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke. Methods: Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors. Results: A total of 714 patients (315 women, 399 men; age 27-97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5-14.9) followed by CIHT (OR 2.7; 95% CI 0.8-9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8-20.8) and for CI (OR 3.1; 95% CI 1.3-7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03-0.8) was a protective factor for IPH. Conclusion: The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke.
UR - http://www.scopus.com/inward/record.url?scp=82955243899&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=82955243899&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e3182364878
DO - 10.1212/WNL.0b013e3182364878
M3 - Article
C2 - 21975208
AN - SCOPUS:82955243899
VL - 77
SP - 1785
EP - 1793
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 20
ER -