EEG patterns and epileptic seizures in acute phase stroke.
1Department of Neurological Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy. oriano.mecarelli@uniroma.it
Cerebrovascular Diseases (Basel, Switzerland)
|December 17, 2010
Summary
Early stroke seizures are uncommon, often presenting as focal status epilepticus (SE). Electroencephalography (EEG) can identify periodic lateralized epileptiform discharges (PLEDs), which are linked to these early seizures in stroke patients.
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Early post-stroke seizures occur in 2-33% of patients.
- Electroencephalography (EEG) is crucial for detecting non-convulsive seizures but isn't routine in acute stroke work-ups.
- Variability in seizure rates is attributed to study design and monitoring methods.
Purpose of the Study:
- Analyze EEG patterns within 24 hours of stroke onset.
- Investigate correlations between EEG patterns and early seizures/status epilepticus (SE).
- Examine associations with vascular risk factors, stroke subtypes, and short-term outcomes.
Main Methods:
- Prospective study of 232 patients (177 ischemic, 55 hemorrhagic strokes).
- EEG recording performed within 24 hours of hospitalization.
- Follow-up duration of 1 week.
Main Results:
- 6.5% of patients experienced early seizures within 24 hours; 10 had focal SE.
- EEG showed sporadic epileptiform abnormalities in 10% and periodic lateralized epileptiform discharges (PLEDs) in 6%.
- PLEDs were associated with SE in 71.4% of cases; early epileptic manifestations independently predicted PLEDs.
Conclusions:
- Early seizures are infrequent post-stroke, predominantly presenting as focal SE.
- EEG can identify patterns like PLEDs, which are strongly associated with early seizures.
- EEG monitoring is recommended for detecting electrographic seizures in acute stroke.
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