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Early EEG Predicts Poststroke Epilepsy

dc.contributor.authorBentes, C
dc.contributor.authorMartins, H
dc.contributor.authorPeralta, AR
dc.contributor.authorMorgado, C
dc.contributor.authorCasimiro, C
dc.contributor.authorFranco, AC
dc.contributor.authorFonseca, AC
dc.contributor.authorGeraldes, R
dc.contributor.authorCanhão, P
dc.contributor.authorPinho e Melo, T
dc.contributor.authorPaiva, T
dc.contributor.authorFerro, J
dc.date.accessioned2019-11-22T16:02:04Z
dc.date.available2019-11-22T16:02:04Z
dc.date.issued2018-06
dc.description.abstractObjective: Electroencephalography (EEG) can identify biomarkers of epileptogenesis and ictogenesis. However, few studies have used EEG in the prediction of poststroke seizures. Our primary aim was to evaluate whether early EEG abnormalities can predict poststroke epilepsy. Methods: A prospective study of consecutive acute anterior circulation ischemic stroke patients, without previous epileptic seizures, who were admitted to a stroke unit over 24 months and followed for 1 year. All patients underwent standardized clinical and diagnostic assessment during the hospital stay and after discharge. Video-EEG was performed in the first 72 h (first EEG), daily for the first 7 days, in case of neurological deterioration, at discharge, and at 12 months after stroke. The occurrence of epileptic seizures in the first year after stroke (primary outcome) was evaluated clinically and neurophysiologically during the hospital stay and at 12 months. A telephone interview was also performed at 6 months. The primary outcome was the occurrence of at least one unprovoked seizure (poststroke epilepsy). Secondary outcomes were the occurrence of at least one acute symptomatic seizure and (interictal and/or ictal) epileptiform activity on at least one EEG during the hospital stay for acute stroke. The first EEG variables were defined using international criteria/terminology. Bivariate and multivariate analyses with adjustment for age, admission National Institutes of Health Stroke Scale (NIHSS) score, and Alberta Stroke Program Early CT Score (ASPECTS) were performed. Results: A total of 151 patients were included; 38 patients (25.2%) had an acute symptomatic seizure and 23 (16%) had an unprovoked seizure.The first EEG background activity asymmetry and first EEG with interictal epileptiform activity were independent predictors of poststroke epilepsy during the first year after stroke (P = 0.043 and P = 0.043, respectively). No EEG abnormality independently predicted acute symptomatic seizures. However, the presence of periodic discharges on the first EEG was an independent predictor of epileptiform activity (p = 0.009) during the hospital stay. Significance: An early poststroke EEG can predict epilepsy in the first year after stroke, independently from clinical and imaging-based infarct severity.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEpilepsia Open. 2018 Mar 7;3(2):203-212.pt_PT
dc.identifier.doi10.1002/epi4.12103pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3363
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectHSJ MEDpt_PT
dc.subjectIschemic Strokept_PT
dc.subjectEpileptic Seizurespt_PT
dc.subjectPredictionpt_PT
dc.subjectEEGpt_PT
dc.subjectProspective Studiespt_PT
dc.titleEarly EEG Predicts Poststroke Epilepsypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage212pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage203pt_PT
oaire.citation.titleEpilepsia Openpt_PT
oaire.citation.volume3pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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