급성허혈뇌졸중 환자의 급성증상발작: 발생률 및예측인자
Acute Symptomatic Seizures in Patients with Acute Ischemic Stroke: Incidence and Predictive Factors
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Background: The aim of this study was to establish the incidence, predictive factors, characteristics, and clinical outcomes of acute symptomatic seizures (ASS) after acute ischemic stroke (AIS). Methods: In total, 2,528 consecutive patients with first-ever AIS were included. Patients with a history of epilepsy or provoked seizures due to tumor, head trauma, brain surgery, or high fever were excluded. Onset seizure (OS) and ASS were defined as seizures occurring within 24 hours and 7 days after AIS, respectively. The incidence of ASS, type of seizures, presence of late unprovoked seizure (LUS), MRI, and electroencephalogram were analyzed. Results: ASS and OS occurred in 23 patients (0.9%) and 15 patients (0.6%), respectively; 20 of the patients with ASS (87.0%) had partial seizures and 4 (17.4%) developed status epilepticus. The incidence rates of ASS were 1.3%, 0.3%, and 0.2% in AIS caused by large-artery atherosclerosis, small-vessel occlusion, and cardioembolism, respectively. Of the 23 patients with ASS, the cortex was involved in 19 (82.6%), 16 patients (69.6%) had medium-sized to large lesions, the anterior circulation territory was involved in 21 patients (91.3%), and 4 patients (17.4%) developed MRI-confirmed hemorrhagic transformation of the lesions. Epileptiform discharges were observed in 9 (45%) of the 20 patients with ASS. Three of the 23 patients with ASS (13.0%) developed LUS. Conclusions: The incidence of ASS was 0.9% and was highest in the large-artery atherosclerosis group. The development of ASS was significantly associated with cortical involvement, medium-sized to large lesions, and lesions in the anterior circulation territory. Three of 23 patients (13%) developed LUS.
Abstract
Background: The aim of this study was to establish the incidence, predictive factors, characteristics, and clinical outcomes of acute symptomatic seizures (ASS) after acute ischemic stroke (AIS). Methods: In total, 2,528 consecutive patients with first-ever AIS were included. Patients with a history of epilepsy or provoked seizures due to tumor, head trauma, brain surgery, or high fever were excluded. Onset seizure (OS) and ASS were defined as seizures occurring within 24 hours and 7 days after AIS, respectively. The incidence of ASS, type of seizures, presence of late unprovoked seizure (LUS), MRI, and electroencephalogram were analyzed. Results: ASS and OS occurred in 23 patients (0.9%) and 15 patients (0.6%), respectively; 20 of the patients with ASS (87.0%) had partial seizures and 4 (17.4%) developed status epilepticus. The incidence rates of ASS were 1.3%, 0.3%, and 0.2% in AIS caused by large-artery atherosclerosis, small-vessel occlusion, and cardioembolism, respectively. Of the 23 patients with ASS, the cortex was involved in 19 (82.6%), 16 patients (69.6%) had medium-sized to large lesions, the anterior circulation territory was involved in 21 patients (91.3%), and 4 patients (17.4%) developed MRI-confirmed hemorrhagic transformation of the lesions. Epileptiform discharges were observed in 9 (45%) of the 20 patients with ASS. Three of the 23 patients with ASS (13.0%) developed LUS. Conclusions: The incidence of ASS was 0.9% and was highest in the large-artery atherosclerosis group. The development of ASS was significantly associated with cortical involvement, medium-sized to large lesions, and lesions in the anterior circulation territory. Three of 23 patients (13%) developed LUS.
참고문헌 (43)
- Forsgren L, "Incidence and clinical characterization of unprovoked seizures in adults: a prospective population-based study", Epilepsia, 37, pp.224~229 (1996)
- Beghi E, "Recommendation for a definition of acute symptomatic seizure", Epilepsia, 51, pp.671~675 (2010)
- Alberti A, "Early seizures in patients with acute stroke: frequency, predictive factors, and effect on clinical outcome", Vasc Health Risk Manag, 4, pp.715~720 (2008)
- Labovitz DL, "Prevalence and predictors of early seizure and status epilepticus after first stroke", Neurology, 57, pp.200~206 (2001)
- Lamy C, "Early and late seizures after cryptogenic ischemic stroke in young adults", Neurology, 60, pp.400~404 (2003)
- So EL, "Population-based study of seizure disorders after cerebral infarction", Neurology, 46, pp.350~355 (1996)
- Procaccianti G, "Seizures in acute stroke: incidence, risk factors and prognosis", Neuroepidemiology, 39, pp.45~50 (2012)
- Alvarez V, "Acute seizures in acute ischemic stroke: does thrombolysis have a role to play?", J Neurol, 260, pp.55~61 (2013)
- Conrad J, "Seizures after cerebrovascular events: risk factors and clinical features", Seizure, 22, pp.275~282 (2013)
- Pezzini A, "Complications of acute stroke and the occurrence of early seizures", Cerebrovasc Dis, 35, pp.444~450 (2013)
- Beghi E, "Incidence and predictors of acute symptomatic seizures after stroke", Neurology, 77, pp.1785~1793 (2011)
- Bladin CF, "Seizures after stroke: a prospective multicenter study", Arch Neurol, 57, pp.1617~1622 (2000)
- Giroud M, "Early seizures after acute stroke: a study of 1,640 cases", Epilepsia, 35, pp.959~964 (1994)
- Gupta SR, "Postinfarction seizures. A clinical study", Stroke, 19, pp.1477~1481 (1988)
- Kilpatrick CJ, "Early seizures after acute stroke. Risk of late seizures", Arch Neurol, 49, pp.509~511 (1992)
- Reith J, "Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study", Stroke, 28, pp.1585~1589 (1997)
- Arboix A, "Predictive factors of early seizures after acute cerebrovascular disease", Stroke, 28, pp.1590~1594 (1997)
- Kilpatrick CJ, "Epileptic seizures in acute stroke", Arch Neurol, 47, pp.157~160 (1990)
- Burn J, "Epileptic seizures after a first stroke: the Oxfordshire Community Stroke Project", BMJ, 315, pp.1582~1587 (1997)
- Lim JK, "Seizure after stroke", J Korean Med Assoc, 33, pp.646~655 (1990)
- Jeun SS, "Seizures after cerebral infarction", J Korean Neurol Assoc, 16, pp.494~499 (1998)
- Kim HJ, "The Clinical Characteristics and the Prognosis of Poststroke Seizures after Ischemic Cerebral Infarction", J Korean Epilep Soc, 10, pp.139~145 (2006)
- Stroke, "Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders", Stroke, 20, pp.1407~1431 (1989)
- Adams HP Jr, "Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment", Stroke, 24, pp.35~41 (1993)
- Fisher RS, "Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)", Epilepsia, 46, pp.470~472 (2005)
- "Korean Stroke Registry"[URL]
- Mohr JP, "The Harvard Cooperative Stroke Registry: a prospective registry", Neurology, 28, pp.754~762 (1978)
- Kunitz SC, "The pilot Stroke Data Bank: definition, design, and data", Stroke, 15, pp.740~746 (1984)
- Bogousslavsky J, "The Lausanne Stroke Registry:analysis of 1,000 consecutive patients with first stroke", Stroke, 19, pp.1083~1092 (1988)
- Sacco RL, "Infarcts of undetermined cause: the NINCDS Stroke Data Bank", Ann Neurol, 25, pp.382~390 (1989)
- Spitzer K, "The Hamburg Stroke Data Bank:goals, design and preliminary results", J Neurol, 236, pp.139~144 (1989)
- Ross DT, "Thalamic retrograde degeneration following cortical injury: an excitotoxic process?", Neuroscience, 35, pp.525~550 (1990)
- Coulter D, "Epilepsy: A comprehensive textbook. Vol. 3", pp.353~366 (2008), Lippincott Williams & Wilkins
- Proctor M, "Epilepsy: A comprehensive textbook. Vol. 3", pp.367~384 (2008), Lippincott Williams & Wilkins
- Lancman ME, "Risk factors for developing seizures after a stroke", Epilepsia, 34, pp.141~143 (1993)
- Awada A, "Late epileptic seizures after cerebral infarction", Acta Neurol Scand, 99, pp.265~268 (1999)
- Pohlmann-Eden B, "The preserved cortical island sign is highly predictive of postischemic seizures", Cerebrovasc Dis, 12, pp.282~ (2001)
- Lossius MI, "Poststroke epilepsy: occurrence and predictors--a long-term prospective controlled study (Akershus Stroke Study)", Epilepsia, 46, pp.1246~1251 (2005)
- Bansil S, "Movement disorders after stroke in adults: a review", Tremor Other Hyperkinet Mov (N Y), 2 (2012)
- Carrera E, "Continuous assessment of electrical epileptic activity in acute stroke", Neurology, 67, pp.99~104 (2006)
- De Reuck J, "EEG findings after a cerebral territorial infarct in patients who develop early-and late-onset seizures", Eur Neurol, 55, pp.209~213 (2006)
- Holmes GL, "The electroencephalogram as a predictor of seizures following cerebral infarction", Clin Electroencephalogr, 11, pp.83~86 (1980)
- Horner S, "EEG, CT and neurosonographic findings in patients with postischemic seizures", J Neurol Sci, 132, pp.57~60 (1995)