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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Cortical myoclonus during IV thrombolysis for ischemic stroke
Carla Bentes1, Rita Peralta1, Pedro Viana2
1Department of Neurology, Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal ; EEG/Sleep Laboratory, Department of Neurology, Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal.
Epilepsy & Behavior Case Reports
|February 11, 2015
Summary
Subtle seizures during thrombolysis for acute ischemic stroke may be misdiagnosed. This case highlights the challenge of recognizing paroxysmal motor behavior using video and EEG analysis.
Area of Science:
- Neurology
- Neurophysiology
Background:
- Acute ischemic stroke treatment involves thrombolysis, often with recombinant tissue plasminogen activator (rt-PA).
- Seizures can occur during rt-PA perfusion, but are rarely reported.
- Subtle, transient seizures may be misidentified as involuntary movements.
Purpose of the Study:
- To highlight the diagnostic challenge of subtle seizures during rt-PA perfusion.
- To emphasize the importance of recognizing paroxysmal motor behavior in stroke patients.
Main Methods:
- Case report of a patient with middle cerebral artery ischemic stroke.
- Utilized video recording and back-average analysis of electroencephalography (EEG).
Main Results:
- Observed subtle involuntary movements in the paretic upper limb during rt-PA perfusion.
- These movements were identified as subtle seizures of cortical origin.
- Demonstrated the utility of video and EEG for diagnosis.
Conclusions:
- Subtle seizures during rt-PA perfusion may be underrecognized or misdiagnosed.
- Clinical and neurophysiological identification is crucial for accurate diagnosis and management.
- Further research is needed to understand the relationship between thrombolysis and epileptic activity.
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