Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion
IntroductionAcute symptomatic seizures (ASz) after ischemic stroke are associated with increased mortality; therefore, identifying predictors of ASz is important. The purpose of this study was to analyze predictors of ASz in a population of patients with ischemic stroke due to large arterial vessel...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.894173/full |
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| author | Lisa Marie Tako Lisa Marie Tako Adam Strzelczyk Adam Strzelczyk Felix Rosenow Felix Rosenow Waltraud Pfeilschifter Helmuth Steinmetz Rejane Golbach Jan Hendrik Schäfer Johann Philipp Zöllner Johann Philipp Zöllner Konstantin Kohlhase |
| author_facet | Lisa Marie Tako Lisa Marie Tako Adam Strzelczyk Adam Strzelczyk Felix Rosenow Felix Rosenow Waltraud Pfeilschifter Helmuth Steinmetz Rejane Golbach Jan Hendrik Schäfer Johann Philipp Zöllner Johann Philipp Zöllner Konstantin Kohlhase |
| author_sort | Lisa Marie Tako |
| collection | DOAJ |
| description | IntroductionAcute symptomatic seizures (ASz) after ischemic stroke are associated with increased mortality; therefore, identifying predictors of ASz is important. The purpose of this study was to analyze predictors of ASz in a population of patients with ischemic stroke due to large arterial vessel occlusion (LVO).Materials and MethodsThis retrospective study examined patients with acute ischemic stroke caused by LVO between 2016 and 2020. Identification of predictive factors was performed using univariate and subsequent multiple logistic regression analysis. In addition, subgroup analysis regarding seizure semiology and time of seizure occurrence (≤ 24 h and > 24 h after stroke) was performed.ResultsThe frequency of ASz among 979 patients was 3.9 % (n = 38). Univariate logistic regression analysis revealed an increased risk of ASz in patients with higher National Institutes of Health Stroke Scale (NIHSS) score at admission or 24 h after admission, hypernatremia at admission ≥ 145 mmol/L, and pneumonia. Further multiple logistic regression analysis revealed that NIHSS 24 h after admission was the strongest predictor of ASz, particularly relating to ASz occurring later than 24 h after stroke. Patients who experienced a seizure within the first 24 h after stroke were more likely to have a generalized tonic-clonic (GTCS) and focal motor seizure; beyond 24 h, seizures with impaired awareness and non-convulsive status epilepticus were more frequent.ConclusionNIHSS score 24 h after admission is a strong predictive factor for the occurrence of ASz in patients with ischemic stroke caused by LVO. The semiology of ASz varied over time, with GTCS occurring more frequently in the first 24 h after stroke. |
| first_indexed | 2024-04-12T11:15:47Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T11:15:47Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-65748040146946bd8e6942dc713b36f32022-12-22T03:35:30ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.894173894173Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel OcclusionLisa Marie Tako0Lisa Marie Tako1Adam Strzelczyk2Adam Strzelczyk3Felix Rosenow4Felix Rosenow5Waltraud Pfeilschifter6Helmuth Steinmetz7Rejane Golbach8Jan Hendrik Schäfer9Johann Philipp Zöllner10Johann Philipp Zöllner11Konstantin Kohlhase12Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyLOEWE Center for Personalized and Translational Epilepsy Research, Goethe University Frankfurt, Frankfurt, GermanyDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyLOEWE Center for Personalized and Translational Epilepsy Research, Goethe University Frankfurt, Frankfurt, GermanyDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyLOEWE Center for Personalized and Translational Epilepsy Research, Goethe University Frankfurt, Frankfurt, GermanyDepartment of Neurology and Neurophysiology, Lüneburg Hospital, Lüneburg, GermanyDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyInstitute of Biostatistics and Mathematical Modelling, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyLOEWE Center for Personalized and Translational Epilepsy Research, Goethe University Frankfurt, Frankfurt, GermanyDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, GermanyIntroductionAcute symptomatic seizures (ASz) after ischemic stroke are associated with increased mortality; therefore, identifying predictors of ASz is important. The purpose of this study was to analyze predictors of ASz in a population of patients with ischemic stroke due to large arterial vessel occlusion (LVO).Materials and MethodsThis retrospective study examined patients with acute ischemic stroke caused by LVO between 2016 and 2020. Identification of predictive factors was performed using univariate and subsequent multiple logistic regression analysis. In addition, subgroup analysis regarding seizure semiology and time of seizure occurrence (≤ 24 h and > 24 h after stroke) was performed.ResultsThe frequency of ASz among 979 patients was 3.9 % (n = 38). Univariate logistic regression analysis revealed an increased risk of ASz in patients with higher National Institutes of Health Stroke Scale (NIHSS) score at admission or 24 h after admission, hypernatremia at admission ≥ 145 mmol/L, and pneumonia. Further multiple logistic regression analysis revealed that NIHSS 24 h after admission was the strongest predictor of ASz, particularly relating to ASz occurring later than 24 h after stroke. Patients who experienced a seizure within the first 24 h after stroke were more likely to have a generalized tonic-clonic (GTCS) and focal motor seizure; beyond 24 h, seizures with impaired awareness and non-convulsive status epilepticus were more frequent.ConclusionNIHSS score 24 h after admission is a strong predictive factor for the occurrence of ASz in patients with ischemic stroke caused by LVO. The semiology of ASz varied over time, with GTCS occurring more frequently in the first 24 h after stroke.https://www.frontiersin.org/articles/10.3389/fneur.2022.894173/fullepilepsyseizureintravenous thrombolysismechanical recanalizationstroke unit |
| spellingShingle | Lisa Marie Tako Lisa Marie Tako Adam Strzelczyk Adam Strzelczyk Felix Rosenow Felix Rosenow Waltraud Pfeilschifter Helmuth Steinmetz Rejane Golbach Jan Hendrik Schäfer Johann Philipp Zöllner Johann Philipp Zöllner Konstantin Kohlhase Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion Frontiers in Neurology epilepsy seizure intravenous thrombolysis mechanical recanalization stroke unit |
| title | Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion |
| title_full | Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion |
| title_fullStr | Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion |
| title_full_unstemmed | Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion |
| title_short | Predictive Factors of Acute Symptomatic Seizures in Patients With Ischemic Stroke Due to Large Vessel Occlusion |
| title_sort | predictive factors of acute symptomatic seizures in patients with ischemic stroke due to large vessel occlusion |
| topic | epilepsy seizure intravenous thrombolysis mechanical recanalization stroke unit |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.894173/full |
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