TY - JOUR
T1 - Seizures in acute stroke
T2 - Incidence, risk factors and prognosis
AU - Procaccianti, Gaetano
AU - Zaniboni, Anna
AU - Rondelli, Francesca
AU - Crisci, Michela
AU - Sacquegna, Tommaso
PY - 2012/7
Y1 - 2012/7
N2 - Background and Purpose: Studies on post-stroke seizures have produced conflicting results. Our study aim was to further elucidate the incidence and predictive factors of early post-stroke seizures (ES) and their relationship with outcome. Methods: relevant clinical data were prospectively collected in 2,053 patients with acute stroke admitted to the Stroke Unit from 2004 to 2008. Results: Sixty-six patients (8 hemorrhagic and 58 ischemic strokes) aged 73-88 years (mean age 82 years) presented seizures in the first week after stroke onset. The type of ischemic stroke was atherothrombotic in 10 patients, cardioembolic in 21, lacunar in 4, undetermined in 19, and of other etiology in 4. Twenty-seven patients had generalized convulsive, 6 had complex partial, and 33 had simple partial seizures. Status epilepticus was observed in 13 patients. The severity of strokes in patients with ES was greater than in those without (National Institutes of Health Stroke Scale >14 in 50 vs. 25%), so mortality (30 days) was higher (29 vs. 14%). Independent seizure predictors were: total anterior circulation infarct, hemorrhagic transformation, hyperglycemia, and the interaction term diabetes × hyperglycemia. Conclusions: ES may be considered a marker of stroke severity. Cortical location of the lesion, hemorrhagic transformation, and hyperglycemia in patients without diabetes are important predictors of ES.
AB - Background and Purpose: Studies on post-stroke seizures have produced conflicting results. Our study aim was to further elucidate the incidence and predictive factors of early post-stroke seizures (ES) and their relationship with outcome. Methods: relevant clinical data were prospectively collected in 2,053 patients with acute stroke admitted to the Stroke Unit from 2004 to 2008. Results: Sixty-six patients (8 hemorrhagic and 58 ischemic strokes) aged 73-88 years (mean age 82 years) presented seizures in the first week after stroke onset. The type of ischemic stroke was atherothrombotic in 10 patients, cardioembolic in 21, lacunar in 4, undetermined in 19, and of other etiology in 4. Twenty-seven patients had generalized convulsive, 6 had complex partial, and 33 had simple partial seizures. Status epilepticus was observed in 13 patients. The severity of strokes in patients with ES was greater than in those without (National Institutes of Health Stroke Scale >14 in 50 vs. 25%), so mortality (30 days) was higher (29 vs. 14%). Independent seizure predictors were: total anterior circulation infarct, hemorrhagic transformation, hyperglycemia, and the interaction term diabetes × hyperglycemia. Conclusions: ES may be considered a marker of stroke severity. Cortical location of the lesion, hemorrhagic transformation, and hyperglycemia in patients without diabetes are important predictors of ES.
KW - Cortical involvement
KW - Hemorrhagic transformation
KW - Hyperglycemia
KW - Seizures
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=84863516617&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863516617&partnerID=8YFLogxK
U2 - 10.1159/000338374
DO - 10.1159/000338374
M3 - Article
C2 - 22777596
AN - SCOPUS:84863516617
VL - 39
SP - 45
EP - 50
JO - Neuroepidemiology
JF - Neuroepidemiology
SN - 0251-5350
IS - 1
ER -