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Early Post-Stroke Seizures in Acute Ischemic Stroke: A Prospective Cohort Study
Ayush Agarwal1, Jyoti Sharma1, M V Padma Srivastava1
1Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Annals of Indian Academy of Neurology
|November 3, 2021
Summary
Early-onset seizures (ES) after ischemic stroke occur in 12.7% of patients and are linked to worse outcomes. A new prediction tool identifies high-risk individuals for potential prophylactic treatment.
Area of Science:
- Neurology
- Stroke Medicine
- Epileptology
Background:
- Stroke is a leading cause of adult epilepsy.
- Post-stroke seizures (PSSs) include early-onset (ES) and late-onset (LS) seizures.
- ES can negatively impact clinical outcomes and increase LS risk.
Purpose of the Study:
- To assess the occurrence of early-onset seizures (ES) in acute ischemic stroke patients.
- To identify predictors of ES.
- To develop a predictive score for ES.
Main Methods:
- Prospective cohort study of 291 acute ischemic stroke patients (June 2018-May 2020).
- ES defined as seizures within 1 week of stroke.
- Logistic regression used to identify ES predictors and develop a prediction score.
Main Results:
- ES occurred in 12.7% of patients.
- Significant ES predictors included cortical location (OR: 4.2), large artery disease (OR: 2.9), mRS at presentation (OR: 1.4), anticoagulant use (OR: 2.6), and hypertension (OR: 0.3).
- ES was associated with significantly worse clinical outcomes at 3 months (P=0.0072).
Conclusions:
- An ES prediction tool was developed using cortical location, large vessel stroke, mRS, anticoagulant use, and hypertension.
- This tool may aid in prophylactic antiepileptic drug (ASD) treatment for high-risk patients.
- Prophylactic treatment could prevent seizures and their complications.
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