OBJECTIVE: To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke. METHODS: Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors. RESULTS: A total of 714 patients (315 women, 399 men; age 27-97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5-14.9) followed by CIHT (OR 2.7; 95% CI 0.8-9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8-20.8) and for CI (OR 3.1; 95% CI 1.3-7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03-0.8) was a protective factor for IPH. CONCLUSION: The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke.
Incidence and predictors of acute symptomatic seizures after stroke / Epistroke Study, Group; Collaborators, ; Silvestrini, Mauro; Provinciali, Leandro; Cagnetti, C; Lamberti, P; La Neve, A; Francavilla, T; Della Porta, R; D'Alessandro, R; Delaj, L; Santagelo, M; Greco, G; Stucchi, Cm; Tola, Mr; Antiga, E; Monetti, C; Fallica, E; Zaccara, G; Ragazzoni, A; Piccininni, M; Balestrieri, F; Muscas, Gc; Melani, F; Specchio, Lm; Pizzolla, P; Mundi, C; Ciampanelli, D; D'Acuino, F; Neri, W; Gessaroli, M; Gandolfo, C; Primavera, A; Pepe, F; Musolino, R; La Spina, P; Dragoferrante, G; Basso, F; Agostoni, E; Gambaro, P; Bortolami, C; Rosa, R; Stival, B; Rebecchi, V; Corato, M; Miceli, G; Meletti, S; Zini, A; Boglium, G; Atzeni, L; Beretta, S; Pagliuca, M; Tessitore, A; de Falco, Fa; Scoditti, U; Iolanda, Am; Baroc, Mf; Marcello, N; Rizzi, R; Rasura, M; Cao, M; Di Lisi, F; Pietrella, A; Terenzi, R; Alberti, F; Traverso, F; Labate, C; Febbraro, A; Mutani, R; Benna, P; Cerrato, P; Montalenti, E; Destefanis, E; De Mattei, M; Bonzanino, M; Marilena, G; Chiodo Grandi, F; Consoli, D; Postorino, P; Crespi, V; Beretta, S; Monaco, F; Savio, K; Bolamperti, L.. - In: NEUROLOGY. - ISSN 0028-3878. - STAMPA. - 77:(2011), pp. 1785-1793. [10.1212/WNL.0b013e3182364878]
Incidence and predictors of acute symptomatic seizures after stroke
SILVESTRINI, Mauro;PROVINCIALI, LEANDRO;
2011-01-01
Abstract
OBJECTIVE: To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke. METHODS: Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors. RESULTS: A total of 714 patients (315 women, 399 men; age 27-97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5-14.9) followed by CIHT (OR 2.7; 95% CI 0.8-9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8-20.8) and for CI (OR 3.1; 95% CI 1.3-7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03-0.8) was a protective factor for IPH. CONCLUSION: The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
