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Published on: June 21, 2019
Reperfusion therapies and poststroke seizures
Carla Bentes1, Francesco Brigo2, Johan Zelano3
1Laboratory of EEG/Sleep, Neurophysiological Monitoring Unit, Department of Neuroscience and Mental Health (Neurology), Hospital de Santa Maria, CHULN, Lisbon, Portugal; Centro de Referência de Epilepsias Refratárias from EpiCare network (European Reference Network for rare and complex Epilepsies), Hospital de Santa Maria, CHULN, Lisbon, Portugal; Department of Neuroscience and Mental Health (Neurology), Hospital de Santa Maria, CHULN, Lisbon, Portugal; Department of Neuroscience and Mental Health (Neurology), Hospital de Santa Maria, CHULN, Lisbon, Portugal.
Reperfusion therapies for stroke may impact seizure risk, but the exact relationship remains unclear. More research is needed to understand how these treatments affect acute symptomatic and unprovoked seizures after stroke.
Area of Science:
- Neurology
- Stroke Medicine
- Epileptology
Background:
- Seizures are a common stroke complication, worsening patient outcomes.
- Acute symptomatic seizures require reevaluation within evolving stroke care standards.
- Reperfusion therapies, standard for ischemic stroke, are linked to seizures and epileptiform activity.
Purpose of the Study:
- To review physiopathological mechanisms linking reperfusion therapies and seizures.
- To examine current evidence on poststroke seizure risk in treated patients.
- To identify knowledge gaps for future research on reperfusion and seizures.
Main Methods:
- Narrative review of existing literature.
- Analysis of physiopathological mechanisms.
- Evaluation of clinical evidence regarding reperfusion therapies and seizure occurrence.
Main Results:
- Reperfusion therapies may have conflicting effects on poststroke seizure risk.
- Current evidence does not strongly associate thrombolysis with poststroke seizures.
- The overall impact of reperfusion on seizure frequency is currently unclear.
Conclusions:
- A clearer definition of seizures and stroke characteristics is needed.
- High-quality, large-scale, prospective studies with long follow-up are essential.
- Stroke registries may aid in clarifying the association between reperfusion therapies and seizures.
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