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Acute Symptomatic Seizures in Patients with Recurrent Ischemic Stroke: A Multicentric Study.

dc.contributor.authorLeal Rato, Miguel
dc.contributor.authorSchön, Miguel
dc.contributor.authorZafra, Maria Paula
dc.contributor.authorAguiar de Sousa, Diana
dc.contributor.authorPinho E Melo, Teresa
dc.contributor.authorFranco, Ana Catarina
dc.contributor.authorPeralta, Ana Rita
dc.contributor.authorFerreira-Atuesta, Carolina
dc.contributor.authorMayor-Romero, Luis Carlos
dc.contributor.authorRouhl, Rob P W
dc.contributor.authorBentes, Carla
dc.date.accessioned2025-07-25T14:03:44Z
dc.date.available2025-07-25T14:03:44Z
dc.date.issued2024-12
dc.description.abstractObjective: Epileptic seizures occur frequently after stroke due to changes in brain function and structure, and up to around 10% of stroke patients experience stroke recurrence in the first year. We aimed to establish the risk of acute symptomatic seizures in patients with recurrent stroke. Methods: Retrospective cohort study including consecutive admissions to a Stroke Unit due to acute ischemic stroke, during a 5-year period. Additional inclusion of patients admitted to two centers in different countries to corroborate findings (confirmatory cohort). We aimed to compare acute symptomatic seizure incidence in patients with and without previous stroke. Patients with history of epilepsy were excluded. Logistic regression modeling was performed to identify predictors in middle cerebral artery (MCA) stroke. Results: We included 1473 patients (1085 with MCA stroke), of which 117 had a recurrent ischemic stroke (84 with MCA stroke). Patients with recurrent stroke had a seizure risk during hospital stay similar to that of patients with a first-ever stroke (5.1% vs. 4.5%, OR 1.15, 95% CI .48-2.71, p = .75). Risk of acute symptomatic seizures was also similar (5.0% vs. 4.1, OR 1.22, 95% CI .29-5.27, p = .78). Older age, female sex, and hemorrhagic transformation were predictors of seizures in patients with a first MCA ischemic stroke, but not in recurrent stroke patients. Electrographic characteristics were similar between the two groups in patients who had an electroencephalogram (46 with first stroke, 5 with recurrent stroke). The low rate of seizures (1.5%) in the confirmatory cohort (n = 198) precluded full comparison with the initial cohort. Nevertheless, the rate of seizures was not higher in stroke recurrence. Significance: History of previous stroke was not associated with an increased risk of acute symptomatic seizures during hospital stay. Larger, prospective studies, with prospective electrophysiological evaluation, are needed to explore the impact of stroke recurrence on seizure risk.eng
dc.identifier.citationEpileptic Disord . 2024 Dec;26(6):787-796
dc.identifier.doi10.1002/epd2.20279
dc.identifier.other39235840
dc.identifier.urihttp://hdl.handle.net/10400.17/5124
dc.language.isoen
dc.peerreviewedyes
dc.publisherWiley
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAged
dc.subject80 and over
dc.subjectInfarction
dc.subjectMiddle Cerebral Artery / complications
dc.subjectMiddle Cerebral Artery / physiopathology
dc.subjectIschemic Stroke* / complications
dc.subjectIschemic Stroke* / epidemiology
dc.subjectRecurrence*
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectSeizures* / etiology
dc.subjectSeizures* / physiopathology
dc.subjectHSJ UCV
dc.titleAcute Symptomatic Seizures in Patients with Recurrent Ischemic Stroke: A Multicentric Study.por
dc.typetext
dspace.entity.typePublication
oaire.citation.endPage796
oaire.citation.issue6
oaire.citation.startPage787
oaire.citation.volume26
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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