Clinical features of poststroke epileptic seizures
https://doi.org/10.14412/2074-2711-2015-1S-47-53
Abstract
Poststroke epileptic seizures are detected in 30–40% of patients over 60 years of age.
Objective: to explore the clinical features of epileptic seizures in stroke, risk factors for their development to form the bases for prediction and elaboration of optimal therapy.
Patients and methods. 468 patients with ischemic stroke were examined. A study group included 265 patients (176 men and 89 women) aged 31–89 years with epileptic seizures; a control group comprised 203 non-epileptic patients (126 men and 77 women) aged 31–91 years. The patients of both groups were matched for age, clinical characteristics, and pathogenetic subtypes of stroke. Instrumental examinations were performed in the attack-free interval. Neurological status was evaluated using the conventional procedure (the National Institute of Health Stroke Scale); brain magnetic resonance imaging (MRI), magnetic resonance angiography, electroencephalography, extraand transcranial duplex sound of cerebral vessels, by estimating the level and degree of stenosis and cerebrovascular responsiveness.
Results and discussion. Focal seizures were noted to more frequently develop with a preponderance of simple partial seizures within the first 7 days of stroke, with neurological worsening in the acute period of the disease. Stroke in the left carotid and vertebrobasilar beds may provoke the development of early seizures. The cortical localization of ischemic foci and pre-stroke chronic brain ischemia with the signs of circulatory comorbidity in the anterior and posterior circulatory systems may be a risk factor of epileptic seizures. There was an association of the type of an epileptic seizure and the size of an ischemic focus, as evidenced by MRI, with a tendency towards the generalization of seizures in the extensive ischemic foci. A tendency toward the generalization of epileptic seizures was established in the development of stroke in the left carotid bed, as well as in critical stenoses and occlusions of the great cerebral vessels.
About the Author
T. V. Danilova
Interregional Clinical Diagnostic Center, Kazan State Medical University, Ministry of Health of Russia, Kazan, Republic of Tatarstan, Russia 12a, Karbyshev St., Kazan 420101, Republic of Tatarstan
Russian Federation
Russian Federation
References
1. Гехт АБ. Эпилепсия у пожилых. Журнал неврологии и психиатрии им. С.С. Корсакова. 2005;(11):66–7. [Gеht AB. Epilepsy at the elderly. Zhurnal nevrologii i psikhiatrii im.S.S. Korsakova. 2005;(11):66–7. (In Russ.)].
2. Власов ПН, Шабасова ЗС, Ялтонский ВМ. Восприятие социальной поддержки у взрослых больных эпилепсией на фоне рациональной противоэпилептической терапии. Неврология, нейропсихиатрия, психосоматика. 2012;(1S):20–4. [Vlasov PN, Shakhabasova ZS, Yaltonsky VM. Adult epileptic patients’ perception of social support during rational antiepileptic therapy. Nevrologiya, neiropsikhiatriya, psikhosomatika=Neurology, Neuropsychiatry, Psychosomatics. 2012;(1S):20–4. (In Russ.)].
3. Карлов ВА. Эпилепсия у детей и взрослых женщин и мужчин. Москва: Медицина; 2010. 720 с. [Karlov WA. Epilepsiya u detey i vzroslykh zhenshchin i muzhchin [Epilepsy at children and adult women and men]. Moscow: Medicine; 2010. 720 p.].
4. Шнайдер НА, Чацкая АВ, Дмитренко ДВ, Шевченко ОИ. Постинсультная эпилепсия. Международный неврологический журнал. 2007;(4):3–7. [Snayder NA, Chatskaya AV, Dmitrenko DV, Shevchenko OI. Postinsultny epilepsy. Mezhdunarodnyy nevrologicheskiy zhurnal. 2007;(4):3–7. (In Russ.)].
5. Рудакова ИГ, Дьячкова ЕЮ, Колчу ИГ. Факторы риска судорожных приступов в остром периоде инсульта. Неврология, нейропсихиатрия, психосоматика. 2013;(1S):4–6. [Rudakova IG, Djachkova EYu, Kolchu IG. Risk of epileptic seizures onset during acute period of stroke. Nevrologiya, neiropsikhiatriya, psikhosomatika=Neurology, Neuropsychiatry, Psychosomatics. 2013;(1S):4–6. (In Russ.)].
6. Forsgren L, Bucht G, Eriksson S, Bergmark L. Incidence and clinical characterization of unprovoked seizures in adults: a prospective population based study. Epilepsia. 1996 Mar;37(3):224–9.
7. Hauser WA, Kurland LT. The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia. 1975 Mar;16:61–6.
8. Barolin GS, Sherzer E. Epileptische Anfalle bei Apoplektikern. Wein Nervenh. 1962;(20):35–47.
9. Bladin CF, Alexandrov AV, Bellavance A, et al. Seizures after stroke: a prospective multicenter study. Arch Neurol. 2000 Nov;57(11):1617–22.
10. Lami C, Domigo V, Semah F, et al. Early and late sizures after cryptogenic ischemic stroke in young adults. Neurology. 2003 Feb 11;60(3):400–4.
11. Kilpatrick CJ, Davis SM, Tress BM, et al. Epileptic seizures in acute stroke. Arch Neurol. 1990 Feb;47(2):157–60.
12. Giroud M, Gras P, Fayolle H, et al. Early seizures after acute stroke: a study of 1640 cases. Epilepsia. 1994 Sep–Oct;35(5):959–64.
13. Гехт АБ, Лебедева АВ, Рулева ЗС и др. Эпилепсия у больных инсультом. Российский медицинский журнал. 2000;(2):14–7. [Geht AB, Lebedeva AV, Ruleva ZS, et al. Epilepsy at patients with a stroke. Rossiyskiy meditsinskiy zhurnal. 2000;(2):14–7. (In Russ.)].
14. Arboix A, Comes E, Garcia-Eroles L, et al. Prognostic value of very early seizure for inhospitality mortality in atherotrombotic infarction. Eur Neurol. 2003;50(2):78–84.
15. Siddiqi SA, Hashmi M, Khan F, Siddiqui KA. Clinical spectrum of post-stroke seizures. J Coll Physicians Surg Pak. 2011 Apr;21(4):214–8. DOI: 04.2011/JCPSP.214218.
16. Camilo O, Darry D, Goldstein B. Seizures and epilepsy after ischemic stroke. Stroke. 2004 Jul;35(7):1769–75. Epub 2004 May 27.
17. Alberti A, Paciaroni M, Caso V, et al. Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome. Vasc Health Risk Manag. 2008;4(3):715–20.
18. Reuck J, Van Maele G. Acute ischemic stroke treatment and the occurrence of seizures. Clin Neurol Neurosurg. 2010 May;112(4):328–31. DOI: 10.1016/j.clineuro.2010.01.004. Epub 2010 Feb 4.
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For citations:
Danilova TV. Clinical features of poststroke epileptic seizures. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(1S):47-53. (In Russ.) https://doi.org/10.14412/2074-2711-2015-1S-47-53
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