TY - JOUR
T1 - Seizures Following Ischemic Stroke
T2 - Frequency of Occurrence and Impact on Outcome in a Long-Term Population-Based Study
AU - Bryndziar, Tomas
AU - Sedova, Petra
AU - Kramer, Neha M.
AU - Mandrekar, Jay
AU - Mikulik, Robert
AU - Brown, Robert D.
AU - Klaas, James P.
N1 - Funding Information:
The project was also supported by European Regional Development Fund —Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123 ) and by European Social Fund and the State Budget of the Czech Republic —Project Young Talent Incubator II (reg. no. CZ.1.07/2.3.00/20.0117 ).
Funding Information:
This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The project was also supported by European Regional Development Fund-Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123) and by European Social Fund and the State Budget of the Czech Republic-Project Young Talent Incubator II (reg. no. CZ.1.07/2.3.00/20.0117).
Publisher Copyright:
© 2015 National Stroke Association.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background and Purpose Seizures are a known complication of ischemic stroke (IS). This study assesses the long-term incidence and characteristics of poststroke seizures in a well-defined population. Methods Using the Rochester Epidemiology Project medical records-linkage system, we identified all incident cases of IS among Rochester, Minnesota, residents from 1990 to 1994 and followed the patients in the comprehensive medical record through March 2014. All patients with poststroke seizures were identified, and data regarding incident IS, seizures, and status at last follow-up were analyzed. Results We identified 489 patients with first IS. Mean follow-up was 6.5 (standard deviation 6.3) years. New onset seizures occurred in 35 patients (7.2%). Patients with poststroke seizure did not differ from those without in terms of IS etiologic subtype (P =.44) or IS risk factors (P >.05). Early seizures (within 14 days of index stroke) developed in 14 patients (40%), the majority within the first 24 hours (n = 9, 64.3%). The median time of seizure onset for the remaining 21 patients was 13.8 months. Functional outcome, as measured by modified Rankin Scale (mRS), was worse following development of poststroke seizures (mean mRS score 2.9 after IS, 3.3 following index seizure; P =.005), and mortality was higher as well, even after adjusting for IS etiologic subtype (HR 1.52, 95% confidence interval 1.07-2.16, P =.02). Conclusion Development of poststroke seizures is an infrequent but significant complication of IS, portending a worse short-term functional outcome and a higher long-term mortality rate. Seizure occurrence did not differ based on IS etiologic subtype or stroke risk factors.
AB - Background and Purpose Seizures are a known complication of ischemic stroke (IS). This study assesses the long-term incidence and characteristics of poststroke seizures in a well-defined population. Methods Using the Rochester Epidemiology Project medical records-linkage system, we identified all incident cases of IS among Rochester, Minnesota, residents from 1990 to 1994 and followed the patients in the comprehensive medical record through March 2014. All patients with poststroke seizures were identified, and data regarding incident IS, seizures, and status at last follow-up were analyzed. Results We identified 489 patients with first IS. Mean follow-up was 6.5 (standard deviation 6.3) years. New onset seizures occurred in 35 patients (7.2%). Patients with poststroke seizure did not differ from those without in terms of IS etiologic subtype (P =.44) or IS risk factors (P >.05). Early seizures (within 14 days of index stroke) developed in 14 patients (40%), the majority within the first 24 hours (n = 9, 64.3%). The median time of seizure onset for the remaining 21 patients was 13.8 months. Functional outcome, as measured by modified Rankin Scale (mRS), was worse following development of poststroke seizures (mean mRS score 2.9 after IS, 3.3 following index seizure; P =.005), and mortality was higher as well, even after adjusting for IS etiologic subtype (HR 1.52, 95% confidence interval 1.07-2.16, P =.02). Conclusion Development of poststroke seizures is an infrequent but significant complication of IS, portending a worse short-term functional outcome and a higher long-term mortality rate. Seizure occurrence did not differ based on IS etiologic subtype or stroke risk factors.
KW - Stroke
KW - TOAST
KW - epidemiology
KW - seizure
UR - http://www.scopus.com/inward/record.url?scp=84960396718&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84960396718&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2015.09.008
DO - 10.1016/j.jstrokecerebrovasdis.2015.09.008
M3 - Article
C2 - 26454641
AN - SCOPUS:84960396718
SN - 1052-3057
VL - 25
SP - 150
EP - 156
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 1
ER -