Late-onset epilepsy predicts stroke: Systematic review and meta-analysis

Area of Science:

• Neurology
• Vascular Neurology
• Epileptology

Background:

• Late-onset epilepsy (LOE) is strongly associated with cerebrovascular disease (CVD), serving as both a marker and a consequence.
• The understanding of LOE as a cerebrovascular phenomenon is still developing.
• LOE is also recognized as a potential early indicator of dementia.

Purpose of the Study:

• To systematically review and analyze the relationship between late-onset epilepsy and cerebrovascular disease.
• To investigate LOE as a potential marker for stroke and dementia.

Main Methods:

• A systematic review of observational, clinical, and radiological studies was conducted.
• A meta-analysis of observational studies was performed to assess the risk of subsequent stroke in patients with LOE.

Main Results:

• Patients with LOE showed a significantly increased risk of subsequent stroke (OR 3.88).
• Clinical and radiological evidence supports the link between LOE and underlying cerebrovascular disease.
• Cerebrovascular disease risk factors are associated with an increased risk of developing LOE.

Conclusions:

• Late-onset epilepsy can precede stroke and dementia, acting as an early marker for cerebrovascular risk.
• Understanding the natural history of LOE is crucial for potential interventions.
• Prospective research is needed to elucidate LOE's natural history and inform disease modification strategies to reduce stroke and dementia sequelae.