| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology, College of Physicians and Surgeons, Columbia University (Drs. Labovitz, Hauser, and Sacco); Gertrude Sergievsky Center, Mailman School of Public Health, Columbia University (Drs. Hauser and Sacco); Stroke Center, St. Luke’s–Roosevelt Hospital Center, New York (Dr. Labovitz); and Epilepsy Division (Dr. Hauser) and Stroke Division (Dr. Sacco), Neurological Institute, Columbia–Presbyterian Center, New York–Presbyterian Hospital, New York.
Address correspondence and reprint requests to Dr. Daniel L. Labovitz, Stroke Center, St. Luke’s–Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025; e-mail: DLL20{at}columbia.edu
BACKGROUND: Early seizure (ES) has been reported in 2% to 6% of strokes and is a predictor of recurrent seizures. Acute stroke has been reported to cause 22% of all cases of status epilepticus in adults. The determinants of ES and status epilepticus (SE) after stroke, however, are not well understood.
METHODS: An incidence study was conducted to identify all cases of first stroke in adult residents of northern Manhattan. Cases of ES and SE within 7 days of stroke were identified through medical record review. Statistical analyses were performed using univariate and multivariate logistic regression models.
RESULTS: The cohort consisted of 904 patients; ES occurred in 37 (4.1%). The frequency of ES by stroke subtype and location was deep infarct 0.6% (2/356), lobar infarct 5.9% (20/341), deep intracerebral hemorrhage (ICH) 4.0% (4/101), lobar ICH 14.3% (7/49), and subarachnoid hemorrhage 8.0% (4/50). SE occurred in 10 patients (1.1%), representing 27.0% of patients with ES. Diabetes, hypertension, current smoking, alcohol use, age, gender, and race/ethnicity were not significant determinants of ES. In a subgroup of patients who had an NIH stroke scale (NIHSS) score recorded, NIHSS score was not an independent predictor of ES in multivariate analysis. After accounting for stroke severity, ES was not a predictor of 30-day case fatality.
CONCLUSIONS: Lesion location and stroke subtype are strong determinants of ES risk, even after adjusting for stroke severity. ES does not predict 30-day mortality. SE occurs in more than one-quarter of patients with ES.
This article has been cited by other articles:
|
|
 |
|
  M. A. Chadehumbe, P. Khatri, J. C. Khoury, K. Alwell, J. P. Szaflarski, J. P. Broderick, B. M. Kissela, and D. O. Kleindorfer Seizures are Common in the Acute Setting of Childhood Stroke: A Population-Based Study J Child Neurol, January 1, 2009; 24(1): 9 - 12. [Abstract] [PDF]
|
|
|
|
 |
|
 J. Claassen, N. Jette, F. Chum, R. Green, M. Schmidt, H. Choi, J. Jirsch, J. A. Frontera, E. S. Connolly, R. G. Emerson, et al. Electrographic seizures and periodic discharges after intracerebral hemorrhage Neurology, September 25, 2007; 69(13): 1356 - 1365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. O. Rossetti, G. Logroscino, L. Liaudet, C. Ruffieux, V. Ribordy, M. D. Schaller, P. A. Despland, and M. Oddo Status epilepticus: An independent outcome predictor after cerebral anoxia Neurology, July 17, 2007; 69(3): 255 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Cordonnier, H. Henon, P. Derambure, F. Pasquier, and D. Leys Early epileptic seizures after stroke are associated with increased risk of new-onset dementia J. Neurol. Neurosurg. Psychiatry, May 1, 2007; 78(5): 514 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ryvlin, A. Montavont, and N. Nighoghossian Optimizing therapy of seizures in stroke patients Neurology, December 26, 2006; 67(12_suppl_4): S3 - S9. [Abstract] [Full Text]
|
|
|
|
|
|
D. R. Chabolla and Z. K. Wszolek Pharmacologic management of seizures in organ transplant Neurology, December 26, 2006; 67(12_suppl_4): S34 - S38. [Abstract] [Full Text]
|
|
|
|
|
|
E. Carrera, P. Michel, P. -A. Despland, M. Maeder-Ingvar, C. Ruffieux, D. Debatisse, J. Ghika, G. Devuyst, and J. Bogousslavsky Continuous assessment of electrical epileptic activity in acute stroke. Neurology, July 11, 2006; 67(1): 99 - 104. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P.N. Sylaja, I. Dzialowski, A. Krol, J. Roy, P. Federico, A. M. Demchuk, and Calgary Stroke Program Role of CT Angiography in Thrombolysis Decision-Making for Patients With Presumed Seizure at Stroke Onset Stroke, March 1, 2006; 37(3): 915 - 917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
NINDS ICH Workshop Participants Priorities for Clinical Research in Intracerebral Hemorrhage: Report From a National Institute of Neurological Disorders and Stroke Workshop Stroke, March 1, 2005; 36(3): e23 - e41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. Marik and J. Varon The Management of Status Epilepticus Chest, August 1, 2004; 126(2): 582 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Camilo and L. B. Goldstein Seizures and Epilepsy After Ischemic Stroke Stroke, July 1, 2004; 35(7): 1769 - 1775. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Devuyst, T. Karapanayiotides, I. Hottinger, G. Van Melle, and J. Bogousslavsky Prodromal and early epileptic seizures in acute stroke: Does higher serum cholesterol protect? Neurology, July 22, 2003; 61(2): 249 - 252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Vespa, K. O'Phelan, M. Shah, J. Mirabelli, S. Starkman, C. Kidwell, J. Saver, M. R. Nuwer, J. G. Frazee, D. A. McArthur, et al. Acute seizures after intracerebral hemorrhage: A factor in progressive midline shift and outcome Neurology, May 13, 2003; 60(9): 1441 - 1446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Lamy, V. Domigo, F. Semah, C. Arquizan, D. Trystram, J. Coste, and J.L. Mas Early and late seizures after cryptogenic ischemic stroke in young adults Neurology, February 11, 2003; 60(3): 400 - 404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. T. Herman Epilepsy after brain insult: Targeting epileptogenesis Neurology, November 12, 2002; 59(90095): S21 - 26. [Abstract] [Full Text]
|
|
|
|
 |
|
 Seizures Accompanying First Stroke: Predictors and Prevalence Journal Watch Neurology, October 5, 2001; 2001(1005): 2 - 2. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
