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Persistent worsening of stroke sequelae after delayed seizures
J Bogousslavsky1, R Martin, F Regli
1Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Archives of Neurology
|April 1, 1992
Summary
Seizures can worsen existing neurological deficits after a stroke. Longer seizures, particularly partial ones, correlate with persistent worsening, suggesting a direct impact on the brain's infarcted areas.
Area of Science:
- Neurology
- Stroke Research
- Epilepsy Studies
Background:
- Cerebral ischemia is a known cause of epilepsy.
- The impact of seizures on stroke sequelae is understudied.
Purpose of the Study:
- To investigate the effect of seizures on neurological deficits in patients with a history of stroke.
- To identify factors associated with worsening of stroke sequelae following seizures.
Main Methods:
- Retrospective analysis of 10 patients with poststroke partial epileptic seizures and persistent deficit worsening.
- Examination of 38 additional patients with poststroke seizures, noting transient worsening (Todd's phenomenon).
- Correlation analysis of seizure characteristics, patient demographics, stroke history, and imaging findings with deficit worsening.
Main Results:
- Ten patients experienced persistent worsening of neurologic deficits after partial epileptic seizures.
- Eight patients had transient neurologic worsening (Todd's phenomenon).
- Persistent worsening was linked to longer seizure duration and longer partial seizures preceding generalization; other factors were not significant. Imaging did not reveal new lesions or infarct extension in most cases.
Conclusions:
- Seizures may cause persistent worsening of neurologic deficits in stroke survivors.
- The direct effect of seizures on infarcted brain tissue is a potential mechanism.
- Further research is needed to understand and manage this phenomenon.