A Comparison of Post-Stroke Seizure Rates in Patients Receiving IV Thrombolytic, Mechanical Thrombectomy, and Conventional Treatment Following Acute Ischemic Stroke
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Abstract
Objective: The incidence of epileptic seizures after a stroke falls within a range of 2.3-43%. Varying opinions exist in the literature concerning the association between thrombolytic therapy, endovascular interventions, and the development of epileptic seizures post-stroke.
Material and Methods: Seizure rates were compared based on the treatment method (thrombolytic therapy, endovascular intervention, or conventional therapy) in patients experiencing acute ischemic stroke within a two-year period in the neurology and neurology intensive care unit. Patients were categorized into three groups: the first group received IV thrombolytic therapy, the second group underwent mechanical thrombectomy, and the third group received conventional therapy. The occurrence of epileptic seizures from hospitalization to discharge was compared.
Results: IV thrombolytics were administered to 1.5% of patients, mechanical thrombectomy to 3.6%, and 94.9% received medical treatment. Epileptic seizures were observed in 0.9% of patients. No statistically significant relationship was found between the development of epileptic seizures and the treatment method for ischemic stroke. Furthermore, no statistically significant correlation was identified between the development of epileptic seizures and the modified Rankin score at discharge.
Conclusion: Our findings align with existing studies. In conclusion, this retrospective study aimed to assess how the treatment method applied in acute ischemic stroke might influence the background of epileptic seizures.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2023-12-04
Published 2023-12-06
References
Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):439–58.
Albers GW, Olivot JM. Intravenous alteplase for ischaemic stroke. The Lancet. 2007 Jan;369(9558):249–50.
Abou-Chebl A. Intra-Arterial Therapy for Acute Ischemic Stroke. Interv Neurol. 2012;1(2):100–8.
Lühdorf K, Jensen LK, Plesner AM. Etiology of Seizures in the Elderly. Epilepsia. 1986 Aug;27(4):458–63.
Camilo O, Goldstein LB. Seizures and Epilepsy After Ischemic Stroke. Stroke. 2004 Jul;35(7):1769–75.
Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Epileptic seizures after a first stroke: the Oxfordshire community stroke project. BMJ. 1997 Dec 13;315(7122):1582–7.
Lo YK, Yiu CH, Hu HH, Su MS, Laeuchli SC. Frequency and characteristics of early seizures in Chinese acute stroke. Acta Neurol Scand. 2009 Jan 29;90(2):83–5.
Silverman IE, Restrepo L, Mathews GC. Poststroke Seizures. Arch Neurol. 2002 Feb 1;59(2):195.
Cheung CM, Tsoi TH, Au-Yeung M, Tang ASY. Epileptic seizure after stroke in Chinese patients. J Neurol. 2003 Jul 1;250(7):839–43.
Sutor B, Luhmann HJ. Involvement of GABA B receptors in convulsant-induced epileptiform activity in rat neocortex in vitro. European Journal of Neuroscience [Internet]. 1998 [cited 2023 Jan 6];10:3417–27.
Demir T, Aslan K, Balal M, Bozdemir H. Clinical features of postroke epilepsy and relationship with prognosis/Inme sonrasi epilepside klinik ozellikler ve prognoz ile iliski. Epilepsi: Journal of the Turkish Epilepsi Society [Internet]. 2013 Sep 1 [cited 2023 Jan 6];19(3):121–7.
Bladin CF. Seizures After Stroke. Arch Neurol. 2000 Nov 1;57(11):1617.
Ryglewicz D, Baranska‐Gieruszczak M, Niedzielska K, Kryst‐Widzgowska T. EEG and CT findings in poststroke epilepsy. Acta Neurol Scand [Internet]. 1990 Jun 1 [cited 2023 Jan 6];81(6):488–90.
Yepes M, Sandkvist M, Coleman TA, Moore E, Wu JY, Mitola D, et al. Regulation of seizure spreading by neuroserpin and tissue-type plasminogen activator is plasminogen-independent. J Clin Invest. 2002 Jun 15;109(12):1571–8.
Hafeez F, Razzaq MA, Levine RL, Ramirez MAN. Reperfusion Seizures: A Manifestation of Cerebral Reperfusion Injury After Administration of Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke. Journal of Stroke and Cerebrovascular Diseases [Internet]. 2007 Nov 1 [cited 2023 Jan 6];16(6):273–7.
Rodan LH, Aviv RI, Sahlas DJ, Murray BJ, Gladstone JP, Gladstone DJ. Seizures during stroke thrombolysis heralding dramatic neurologic recovery. Neurology [Internet]. 2006 Dec 12 [cited 2023 Jan 6];67(11):2048–9.
Alvarez V, Rossetti AO, Papavasileiou V, Michel P. Acute seizures in acute ischemic stroke: does thrombolysis have a role to play?
Vernino S, Brown RD, Sejvar JJ, Sicks JD, Petty GW, O’Fallon WM. Cause-Specific Mortality After First Cerebral Infarction. Stroke. 2003 Aug;34(8):1828–32.
Lancman ME, Golimstok A, Norscini J, Granillo R. Risk Factors for Developing Seizures After a Stroke. Epilepsia. 1993 Jan;34(1):141–3.
IŞIKAY CT; MN. Strok komplikasyonlan. In: serebrovasküler hastalıklar (Balkan S Ed) Ankara Güneş Kitabevi Yayın. 2002. p. 313–28.
Hanna El-Hayek Y, Wu C, Chen R, Al-Sharif AR, Huang S, Patel N, et al. Acute Postischemic Seizures Are Associated with Increased Mortality and Brain Damage in Adult Mice. Cerebral Cortex December [Internet]. 2011 [cited 2023 Jan 6];21:2863–75.