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Cerebral embolism and epileptic seizures--the role of the embolic source
Insights
Epileptic seizures from artery-to-artery embolism strokes occurred later and in more males with abnormal EEGs than cardiac embolism strokes. This research differentiates seizure causes after ischemic stroke.
Area of Science:
- Neurology
- Cardiology
- Stroke Medicine
Background:
- Epileptic seizures are a known complication of ischemic stroke (IS).
- Distinguishing the embolic source of IS is crucial for understanding seizure development.
- Cardiac and artery-to-artery embolism are significant causes of IS.
Purpose of the Study:
- To compare the clinical outcomes of epileptic seizures resulting from cardiac embolism versus artery-to-artery embolism in ischemic stroke patients.
- To identify differentiating factors between these two embolic sources in the context of post-stroke seizures.
Main Methods:
- Retrospective analysis of 174 patients with supratentorial ischemic stroke.
- Classification of seizures based on suspected embolic source: cardiac embolism or artery-to-artery embolism.
- Utilized clinical data, neuroimaging, and cardiovascular tests for differentiation.
Main Results:
- 13 patients experienced seizures due to cardiac embolism; 11 due to artery-to-artery embolism.
- Cardiac embolism group: Equal sex distribution, 6/13 with EEG abnormalities, seizures at ~222 days post-stroke.
- Artery-to-artery embolism group: 9 males/2 females, 10/11 with EEG abnormalities, seizures at ~447 days post-stroke.
Conclusions:
- Seizures from artery-to-artery embolism show male predominance and higher EEG abnormality rates.
- Symptomatic seizures appear significantly later in artery-to-artery embolism compared to cardiac embolism.
- These findings aid in differentiating embolic sources for ischemic stroke-related epilepsy.
Objectives:
To study the clinical outcome of patients with epileptic seizures due to ischemic stroke (IS) of cardiac or artery-to-artery embolism.
Methods:
Seizures due to IS of cardiac or artery-to-artery embolism are differentiated by clinical, neuroimaging and cardiovascular test data.
Results:
From 174 cases with supratentorial IS, 13 patients suffered from epileptic seizures due to cardiac embolism, 11 patients due to artery-to-artery embolism. The patients with cardiac IS showed an equal sex distribution and EEG abnormalities in 6 patients, the initial seizure occurred on average after 222 days (SD, +/-69 days). Among the 11 patients with artery-to-artery embolic IS, there were 9 males and 2 females and EEG abnormalities in 10 patients. The initial seizure occurred on average after 447 days (SD, +/-177 days).
Conclusion:
In seizures due to artery-to-artery embolism, there is a male preponderance and a higher incidence of EEG abnormalities, symptomatic seizures appear later compared to IS due to cardiac embolism.