Acute symptomatic seizures and epilepsy after mechanical thrombectomy

Area of Science:

• Neurology
• Stroke Medicine
• Epileptology

Background:

• Mechanical thrombectomy is a critical treatment for acute ischemic stroke.
• Understanding the risk of poststroke epilepsy (PSE) after this intervention is crucial for patient management.
• Biomarkers of brain injury may offer insights into seizure development.

Purpose of the Study:

• To determine the incidence of acute symptomatic seizures and PSE in patients undergoing mechanical thrombectomy.
• To analyze the dynamics of specific blood markers of brain injury in patients who developed PSE.

Main Methods:

• Prospective cohort study (AnStroke Trial) including patients treated with mechanical thrombectomy.
• Ascertainment of acute symptomatic seizures and PSE through medical records review.
• Measurement of blood biomarkers: neurofilament light (NFL), tau, glial fibrillary acidic protein (GFAP), S100B, and neuron-specific enolase (NSE).

Main Results:

• 90 patients with acute anterior ischemic stroke were included; 90% achieved recanalization.
• Low incidence observed: 4.4% experienced acute symptomatic seizures, and 4.4% developed PSE.
• Estimated two-year PSE risk was 5.3%; elevated blood biomarkers were noted in patients with PSE.

Conclusions:

• Poststroke epilepsy incidence following mechanical thrombectomy is low in this cohort.
• Blood biomarkers showed potential utility in assessing PSE risk, though further research is needed.
• Additional studies are required to identify risk factors for PSE after mechanical thrombectomy.