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Journal of Neurology
Published in: Journal of Neurology 9/2017

01-09-2017 | Original Communication

Post-stroke seizures are clinically underestimated

Authors: Carla Bentes, Hugo Martins, Ana Rita Peralta, Carlos Casimiro, Carlos Morgado, Ana Catarina Franco, Ana Catarina Fonseca, Ruth Geraldes, Patrícia Canhão, Teresa Pinho e Melo, Teresa Paiva, José M. Ferro

Published in: Journal of Neurology | Issue 9/2017

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Abstract

Cerebrovascular disease is the leading cause of epilepsy in adults, although post-stroke seizures reported frequency is variable and few studies used EEG in their identification. To describe and compare EEG and clinical epileptic manifestations frequency in patients with an anterior circulation ischaemic stroke. Prospective study of acute anterior circulation ischaemic stroke patients, consecutively admitted to a Stroke Unit over 24 months and followed-up for 1 year. All patients underwent standardized clinical and diagnostic assessment. Seizure occurrence was clinically evaluated during hospitalization and by a telephone interview at 6 months and a clinical appointment at 12 months after stroke. Video-EEG was performed in the first 72 h (1st EEG), daily after the 1st EEG for the first 7 days after the stroke, or later if neurological worsening, at discharge, and at 12 months. 151 patients were included (112 men) with a mean age of 67.4 (11.9) years. In the 1st year after stroke, 38 patients (25.2%) had an epileptic seizure. During hospitalization, 27 patients (17.9%) had epileptiform activity (interictal or ictal) in the EEG, 7 (25.9%) of them electrographic seizures. During the first week after stroke, 22 (14.6%) patients had a seizure and 4 (2.6%) non-convulsive status epilepticus criteria. Five (22.7%) acute symptomatic seizures were exclusively electrographic. At least one remote symptomatic seizure occurred in 23 (16%) patients. In the first 7 days after stroke, more than one-fifth of patients with seizures had exclusively electrographic seizures. Without a systematic neurophysiological evaluation the frequency of post-stroke seizures are clinically underestimated.
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Metadata
Title
Post-stroke seizures are clinically underestimated
Authors
Carla Bentes
Hugo Martins
Ana Rita Peralta
Carlos Casimiro
Carlos Morgado
Ana Catarina Franco
Ana Catarina Fonseca
Ruth Geraldes
Patrícia Canhão
Teresa Pinho e Melo
Teresa Paiva
José M. Ferro
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 9/2017
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-017-8586-9

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