RISK FACTORS FOR THE DEVELOPMENT OF SYMPTOMATIC EPILEPSY IN PATIENTS DIAGNOSED WITH STROKE

  • Biljana Živadinović
  • Aleksandra Lučić –Prokin3
  • , Jelena Živadinović
  • Aleksandar Stojanov
Keywords: risk factors, epilepsy, stroke

Abstract


Stroke is one of the leading causes of mortality in older population. Little less than 50% of patients with stroke remain with different degrees of disabilities and consequences. Symptomatic epilepsy (PSE) is one of them. The aims of the study were to determine the frequency of PSE in the group of examinees, the difference in the frequency of PSE in the ischemic stroke and intracerebral hemorrhage (ICH) group, the influence of the size and location of the lesion, as well as the influence of comorbidity on the occurrence of PSE.

This prospective study analyzed patients with the first stroke of ischemic and hemorrhagic genesis with the follow up period of two years.

Out of the total of 536 patients, 267 patients (aged 47−92) who had the first stroke, were analyzed. In the control group (n = 246), PSE did not develop after stroke, and the other group (n=21) included patients who had PSE. Cortical and subcortical lesions had a statistically significant (p < 0.05) influence on the development of epileptic seizures after stroke. A statistical significance between the size of the lesion as well as the type of stroke and PSE was not determined. The combination of cardiovascular and pulmonary disease was statistically significantly more often associated with the development of PSE after stroke (p < 0.05).

The frequency of PSE in the examined group was 7.86%. Younger age, as well as cortical and subcortical lesion, was shown to be statistically significant for the occurrence of PSE. The presence of cardiac and pulmonary disease significantly increases the risk of PSE. Although the significance of ICH and big lesion for the onset of PSE has been described in the literature, we have not found statistical significance regarding their impact on PSE occurrence in our experimental group of patients.

References

800x600

Normal

0

false

false

false

EN-US

X-NONE

X-NONE

DefSemiHidden="false" DefQFormat="false" DefPriority="99"

LatentStyleCount="371">

UnhideWhenUsed="true" QFormat="true" Name="heading 2"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 3"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 4"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 5"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 6"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 7"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 8"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 9"/>

Name="index 1"/>

Name="index 2"/>

Name="index 3"/>

Name="index 4"/>

Name="index 5"/>

Name="index 6"/>

Name="index 7"/>

Name="index 8"/>

Name="index 9"/>

UnhideWhenUsed="true" Name="toc 1"/>

UnhideWhenUsed="true" Name="toc 2"/>

UnhideWhenUsed="true" Name="toc 3"/>

UnhideWhenUsed="true" Name="toc 4"/>

UnhideWhenUsed="true" Name="toc 5"/>

UnhideWhenUsed="true" Name="toc 6"/>

UnhideWhenUsed="true" Name="toc 7"/>

UnhideWhenUsed="true" Name="toc 8"/>

UnhideWhenUsed="true" Name="toc 9"/>

Name="Normal Indent"/>

Name="footnote text"/>

Name="annotation text"/>

Name="header"/>

Name="footer"/>

Name="index heading"/>

UnhideWhenUsed="true" QFormat="true" Name="caption"/>

Name="table of figures"/>

Name="envelope address"/>

Name="envelope return"/>

Name="footnote reference"/>

Name="annotation reference"/>

Name="line number"/>

Name="page number"/>

Name="endnote reference"/>

Name="endnote text"/>

Name="table of authorities"/>

Name="macro"/>

Name="toa heading"/>

Name="List"/>

Name="List Bullet"/>

Name="List Number"/>

Name="List 2"/>

Name="List 3"/>

Name="List 4"/>

Name="List 5"/>

Name="List Bullet 2"/>

Name="List Bullet 3"/>

Name="List Bullet 4"/>

Name="List Bullet 5"/>

Name="List Number 2"/>

Name="List Number 3"/>

Name="List Number 4"/>

Name="List Number 5"/>

Name="Closing"/>

Name="Signature"/>

UnhideWhenUsed="true" Name="Default Paragraph Font"/>

UnhideWhenUsed="true" Name="Body Text"/>

Name="Body Text Indent"/>

Name="List Continue"/>

Name="List Continue 2"/>

Name="List Continue 3"/>

Name="List Continue 4"/>

Name="List Continue 5"/>

Name="Message Header"/>

Name="Salutation"/>

Name="Date"/>

Name="Body Text First Indent"/>

Name="Body Text First Indent 2"/>

Name="Note Heading"/>

Name="Body Text 2"/>

Name="Body Text 3"/>

Name="Body Text Indent 2"/>

Name="Body Text Indent 3"/>

Name="Block Text"/>

Name="Hyperlink"/>

Name="FollowedHyperlink"/>

Name="Document Map"/>

Name="Plain Text"/>

Name="E-mail Signature"/>

Name="HTML Top of Form"/>

Name="HTML Bottom of Form"/>

Name="Normal (Web)"/>

Name="HTML Acronym"/>

Name="HTML Address"/>

Name="HTML Cite"/>

Name="HTML Code"/>

Name="HTML Definition"/>

Name="HTML Keyboard"/>

Name="HTML Preformatted"/>

Name="HTML Sample"/>

Name="HTML Typewriter"/>

Name="HTML Variable"/>

Name="Normal Table"/>

Name="annotation subject"/>

Name="No List"/>

Name="Outline List 1"/>

Name="Outline List 2"/>

Name="Outline List 3"/>

Name="Table Simple 1"/>

Name="Table Simple 2"/>

Name="Table Simple 3"/>

Name="Table Classic 1"/>

Name="Table Classic 2"/>

Name="Table Classic 3"/>

Name="Table Classic 4"/>

Name="Table Colorful 1"/>

Name="Table Colorful 2"/>

Name="Table Colorful 3"/>

Name="Table Columns 1"/>

Name="Table Columns 2"/>

Name="Table Columns 3"/>

Name="Table Columns 4"/>

Name="Table Columns 5"/>

Name="Table Grid 1"/>

Name="Table Grid 2"/>

Name="Table Grid 3"/>

Name="Table Grid 4"/>

Name="Table Grid 5"/>

Name="Table Grid 6"/>

Name="Table Grid 7"/>

Name="Table Grid 8"/>

Name="Table List 1"/>

Name="Table List 2"/>

Name="Table List 3"/>

Name="Table List 4"/>

Name="Table List 5"/>

Name="Table List 6"/>

Name="Table List 7"/>

Name="Table List 8"/>

Name="Table 3D effects 1"/>

Name="Table 3D effects 2"/>

Name="Table 3D effects 3"/>

Name="Table Contemporary"/>

Name="Table Elegant"/>

Name="Table Professional"/>

Name="Table Subtle 1"/>

Name="Table Subtle 2"/>

Name="Table Web 1"/>

Name="Table Web 2"/>

Name="Table Web 3"/>

Name="Balloon Text"/>

Name="Table Theme"/>

Name="List Paragraph"/>

Name="Intense Quote"/>

Name="Subtle Emphasis"/>

Name="Intense Emphasis"/>

Name="Subtle Reference"/>

Name="Intense Reference"/>

UnhideWhenUsed="true" Name="Bibliography"/>

UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>

Name="Grid Table 1 Light Accent 1"/>

Name="Grid Table 6 Colorful Accent 1"/>

Name="Grid Table 7 Colorful Accent 1"/>

Name="Grid Table 1 Light Accent 2"/>

Name="Grid Table 6 Colorful Accent 2"/>

Name="Grid Table 7 Colorful Accent 2"/>

Name="Grid Table 1 Light Accent 3"/>

Name="Grid Table 6 Colorful Accent 3"/>

Name="Grid Table 7 Colorful Accent 3"/>

Name="Grid Table 1 Light Accent 4"/>

Name="Grid Table 6 Colorful Accent 4"/>

Name="Grid Table 7 Colorful Accent 4"/>

Name="Grid Table 1 Light Accent 5"/>

Name="Grid Table 6 Colorful Accent 5"/>

Name="Grid Table 7 Colorful Accent 5"/>

Name="Grid Table 1 Light Accent 6"/>

Name="Grid Table 6 Colorful Accent 6"/>

Name="Grid Table 7 Colorful Accent 6"/>

Name="List Table 1 Light Accent 1"/>

Name="List Table 6 Colorful Accent 1"/>

Name="List Table 7 Colorful Accent 1"/>

Name="List Table 1 Light Accent 2"/>

Name="List Table 6 Colorful Accent 2"/>

Name="List Table 7 Colorful Accent 2"/>

Name="List Table 1 Light Accent 3"/>

Name="List Table 6 Colorful Accent 3"/>

Name="List Table 7 Colorful Accent 3"/>

Name="List Table 1 Light Accent 4"/>

Name="List Table 6 Colorful Accent 4"/>

Name="List Table 7 Colorful Accent 4"/>

Name="List Table 1 Light Accent 5"/>

Name="List Table 6 Colorful Accent 5"/>

Name="List Table 7 Colorful Accent 5"/>

Name="List Table 1 Light Accent 6"/>

Name="List Table 6 Colorful Accent 6"/>

Name="List Table 7 Colorful Accent 6"/>

/* Style Definitions */

table.MsoNormalTable

{mso-style-name:"Table Normal";

mso-tstyle-rowband-size:0;

mso-tstyle-colband-size:0;

mso-style-noshow:yes;

mso-style-priority:99;

mso-style-parent:"";

mso-padding-alt:0in 5.4pt 0in 5.4pt;

mso-para-margin:0in;

mso-para-margin-bottom:.0001pt;

mso-pagination:widow-orphan;

font-size:10.0pt;

font-family:"Times New Roman","serif";}

1.   Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44(7): 2064-89. Erratum in: Stroke 2019; 50(8): e239. [CrossRef] [PubMed]

2.   Marciniec M, Popek-Marciniec S, Kulczyński M, Pasterczyk K, Szczepańska-Szerej A, Rejdak K. Prevention of seizures after ischemic stroke: association between statin use and the risk  of seizures. World Sci News 2018; 99: 181-92. http://www.worldscientificnews.com/wp-content/uploads/2018/04/WSN-99-2018-181-192.pdf

3.   Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014; 55(4): 475-82. [CrossRef] [PubMed]

4.   Merkler AE, Gialdini G, Lerario MP, Parikh NS, Morris NA, Kummer B, et al. Population-Based Assessment of the Long-Term Risk of Seizures in Survivors of Stroke. Stroke 2018; 49(6): 1319-24. [CrossRef] [PubMed]

5.   Van Tuijl JH, Van Raak EPM, Van Oostenbrugge RJ, Aldenkamp AP, Rouhl RPW. The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study. J Neurol 2018; 265(8): 1780-8. [CrossRef] [PubMed]

6.   Ferro JM, Pinto F. Poststroke epilepsy: epidemiology, pathophysiology and management. Drugs Aging 2004; 21(10): 639-53. [CrossRef] [PubMed]

7.   Camilo O, Goldstein LB. Seizures and epilepsy after ischemic stroke. Stroke 2004; 35(7): 1769-75. [CrossRef] [PubMed]

8.   Yang H, Rajah G, Guo A, Wang Y, Wang Q. Pathogenesis of epileptic seizures and epilepsy after stroke. Neurol Res 2018; 40(6): 426-32. [CrossRef] [PubMed]

9.   Tanaka T, Ihara M. Post-stroke epilepsy. Neurochem Int 2017; 107: 219-28. [CrossRef] [PubMed]

10.       Lyden PD, Lu M, Levine SR, Brott TG, Broderick J. NINDS rtPA Stroke Study Group. A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity. Stroke 2001; 32(6): 1310-7. [CrossRef] [PubMed]

11.       Syvertsen M, Nakken KO, Edland A, Hansen G, Hellum MK, Koht J. Prevalence and etiology of epilepsy in a Norwegian county-A population based study. Epilepsia 2015; 56(5): 699-706. [CrossRef] [PubMed]

12.       Beleza P. Acute symptomatic seizures: a clinically oriented review. Neurologist 2012; 18(3): 109-19. [CrossRef] [PubMed]

13.       De Herdt V, Dumont F, Hénon H, Derambure P, Vonck K, Leys D, et al. Early seizures in intracerebral hemorrhage: incidence, associated factors, and outcome. Neurology 2011; 77(20): 1794-800. [CrossRef] [PubMed]

14.       Arntz RM, Maaijwee NA, Rutten-Jacobs LC, Schoonderwaldt HC, Dorresteijn LD, Van Dijk EJ, et al. Epilepsy after TIA or stroke in young patients impairs long-term functional outcome: the FUTURE Study. Neurology 2013; 81(22): 1907-13. [CrossRef] [PubMed]

15.       Arntz R, Rutten-Jacobs L, Maaijwee N, Schoonderwaldt H, Dorresteijn L, Van Dijk E, et al. Post-stroke epilepsy in young adults: a long-term follow-up study. PLoS One 2013; 8(2): e55498. [CrossRef] [PubMed]

16.       Arntz RM, Rutten-Jacobs LC, Maaijwee NA, Schoonderwaldt HC, Dorresteijn LD, van Dijk EJ, et al. Poststroke epilepsy is associated with a high mortality after a stroke at young age: follow-up of transient ischemic attack and stroke patients and unelucidated risk factor evaluation study. Stroke 2015; 46(8): 2309-11. [CrossRef] [PubMed]

17.       Conrad J, Pawlowski M, Dogan M, Kovac S, Ritter MA, Evers S. Seizures after cerebrovascular events: risk factors and clinical features. Seizure 2013; 22(4): 275-82. [CrossRef] [PubMed]

18.       Misirli H, Ozge A, Somay G, Erdoğan N, Erkal H, Erenoğlu NY. Seizure development after stroke. Int J Clin Pract 2006; 60(12): 1536-41. [CrossRef] [PubMed]

19.       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; 315(7122): 1582-7. [CrossRef] [PubMed]

20.       Sarecka-Hujar B, Kopyta I. Poststroke epilepsy: current perspectives on diagnosis and treatment. Neuropsychiatr Dis Treat 2018; 15: 95-103. [CrossRef] [PubMed]

21.       Graham NS, Crichton S, Koutroumanidis M, Wolfe CD, Rudd AG. Incidence and associations of poststroke epilepsy: the prospective South London Stroke Register. Stroke 2013; 44(3): 605-11. [CrossRef] [PubMed]

22.       Bladin CF, Alexandrov AV, Bellavance A, Bornstein N, Chambers B, Coté R, et al. Seizures after stroke: a prospective multicenter study. Arch Neurol 2000; 57(11): 1617-22. [CrossRef] [PubMed]

23.       Chiu D, Peterson L, Elkind MSV, Rosand J, Gerber LM, Silverstein MD; Glycine Antagonist in Neuroprotection (GAIN) Americas Trial Investigators. Comparison of outcomes after intracerebral hemorrhage and ischemic stroke. J Stroke Cerebrovasc Dis. 2010; 19(3): 225-9. [CrossRef] [PubMed]

24.       Di Maio R. Neuronal mechanisms of epileptogenesis. Front Cell Neurosci 2014; 8: 29. [CrossRef] [PubMed]

25.       Zelano J. Poststroke epilepsy: update and future directions. Ther Adv Neurol Disord 2016; 9(5): 424-35. [CrossRef] [PubMed]

26.       Beghi E, D'Alessandro R, Beretta S, Consoli D, Crespi V, Delaj L, et al. Incidence and predictors of acute symptomatic seizures after stroke. Neurology 2011; 77(20): 1785-93. [CrossRef] [PubMed]

27.       Lamy C, Domigo V, Semah F, Arquizan C, Trystram D, Coste J, et al. Early and late seizures after cryptogenic ischemic stroke in young adults. Neurology 2003; 60(3): 400-4. [CrossRef] [PubMed]

28.       Reith J, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study. Stroke 1997; 28(8): 1585-9. [CrossRef] [PubMed]

29.       Jungehulsing GJ, Heuschmann PU, Holtkamp M, Schwab S, Kolominsky-Rabas PL. Incidence and predictors of post-stroke epilepsy. Acta Neurol Scand 2013; 127(6): 427-30. [CrossRef] [PubMed]

30.       Boison D, Sandau US, Ruskin DN, Kawamura M Jr, Masino SA. Homeostatic control of brain function - new approaches to understand epileptogenesis. Front Cell Neurosci 2013; 7: 109. [CrossRef] [PubMed]

31.       Henshall DC, Engel T. Contribution of apoptosis-associated signaling pathways to epileptogenesis: lessons from Bcl-2 family knockouts. Front Cell Neurosci 2013; 7: 110. [CrossRef] [PubMed]

32.       Hamer HM. Epileptische Anfälle und Epilepsien nach "Schlaganfall" [Seizures and epilepsies after stroke]. Nervenarzt 2009; 80(4): 405-14. [CrossRef] [PubMed]

33.       Gilad R, Sadeh M, Rapoport A, Dabby R, Boaz M, Lampl Y. Monotherapy of lamotrigine versus carbamazepine in patients with poststroke seizure. Clin Neuropharmacol 2007; 30(4):189-95. [CrossRef] [PubMed]

34.       Sykes L, Wood E, Kwan J. Antiepileptic drugs for the primary and secondary prevention of seizures after stroke. Cochrane Database Syst Rev 2014; (1): CD005398. [CrossRef] [PubMed]

35.       Qian C, Löppönen P, Tetri S, Huhtakangas J, Juvela S, Turtiainen HM, et al. Immediate, early and late seizures after primary intracerebral hemorrhage. Epilepsy Res 2014; 108(4): 732-9. [CrossRef] [PubMed]

Published
2023/04/11
Section
Original article