Incidence and Predictors of Acute Symptomatic Seizures After Stroke at A Tertiary Care Hospital

Incidence and Predictors of Acute Symptomatic Seizures

Authors

  • Syed Gohar Ali Liaquat University Hospital, Hyderabad, Pakistan
  • Fezan Hyder United Medical & Dental College, Karachi, Pakistan
  • Monika Kumari Jinnah Medical and Dental College, Karachi, Pakistan
  • Sidra Jazil Faruqi Hamdard University, Karachi, Pakistan
  • Irfana Abbasi Chandka Medical College Hospital, Larkana, Pakistan
  • Naila Naeem Shahbaz Dow University of Health Sciences, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i04.689

Keywords:

Acute Ischemic Stroke, Associated Factors, Seizure, Delay, Family History

Abstract

Neurological deterioration can occur in approximately 15% of patients with acute stroke. Several mechanisms can lead to ischemic lesion extension and subsequent neurological worsening, including re-occlusion, edema progression, and cardiovascular instability. Stroke is one of the main causes of morbidity and mortality worldwide. Objective: To determine the Incidence and predictors of acute symptomatic seizures after stroke at a tertiary care hospital. Methods: This Descriptive Cross-Sectional Study was conducted at Department of Neurology, Civil Hospital, Karachi, Pakistan, from April 19, 2019 to October 18, 2019. Informed consent from all the patients who fulfilled the inclusion criteria was taken after explaining the procedure, risks and benefits of the study. CT scan & continuous twelve-lead ECG were performed. Assessment for associated factors of ischemic stroke i.e., seizure, atrial fibrillation and family history of stroke were noted. All the collected data were entered into the proforma attached at the end and used electronically for research purpose. Results: Mean ± SD of age was found to be 63.14±16.7 years. Out of 251 patients, 137 (54.6%) patients were male and 114 (45.4%) were female. Diabetes Mellitus was noted in 97 (38.6%) patients. Factors associated with acute ischemic stroke i.e., seizure was noted in 31 (12.1%) while atrial fibrillation was noted in 68 (27.1%) patients and positive family history of stroke was documented in 46 (18.3%). Conclusions: It is to be concluded that atrial fibrillation was found to be the major modifiable associated factors in the development of stroke. Controlling of these risk factors might reduce the risk of stroke.  

References

Bennett DA, Krishnamurthi RV, Barker-Collo S, Forouzanfar MH, Naghavi M, Connor M, et al. The global burden of ischemic stroke: findings of the GBD 2010 study. Global heart. 2014 Mar; 9(1):107-12. doi: 10.1016/j.gheart.2014.01.001

Edwards JD, Kapral MK, Fang J, Swartz RH. Long-term morbidity and mortality in patients without early complications after stroke or transient ischemic attack. Cmaj. 2017 Jul; 189(29): E954-61. doi: 10.1503/cmaj.161142

Stefanidou M, Das RR, Beiser AS, Sundar B, Kelly-Hayes M, Kase CS, Devinsky O, et al. Incidence of seizures following initial ischemic stroke in a community-based cohort: the Framingham Heart Study. Seizure. 2017 Apr; 47: 105-10. doi: 10.1016/j.seizure.2017.03.009

Pitkänen A, Roivainen R, Lukasiuk K. Development of epilepsy after ischaemic stroke. The Lancet Neurology. 2016 Feb; 15(2): 185-97. doi: 10.1016/S1474-4422(15)00248-3

Freund P, Friston K, Thompson AJ, Stephan KE, Ashburner J, Bach DR, et al. Embodied neurology: an integrative framework for neurological disorders. Brain. 2016 Jun; 139(6): 1855. doi: 10.1093/brain/aww076

Gooshe M, Abdolghaffari AH, Aleyasin AR, Chabouk L, Tofigh S, Hassanzadeh GR, et al. Hypoxia/ischemia a key player in early post stroke seizures: modulation by opioidergic and nitrergic systems. European journal of pharmacology. 2015 Jan; 746: 6-13. doi: 10.1016/j.ejphar.2014.11.005

Xu LJ, Ouyang YB, Xiong X, Stary CM, Giffard RG. Post-stroke treatment with miR-181 antagomir reduces injury and improves long-term behavioral recovery in mice after focal cerebral ischemia. Experimental neurology. 2015 Feb; 264: 1-7. doi: 10.1016/j.expneurol.2014.11.007

Cheng SY, Zhao YD, Li J, Chen XY, Wang RD, Zeng JW. Plasma levels of glutamate during stroke is associated with development of post-stroke depression. Psychoneuroendocrinology. 2014 Sep; 47: 126-35. doi: 10.1016/j.psyneuen.2014.05.006

Benson J, Payabvash S, Salazar P, Jagadeesan B, Palmer CS, Truwit CL, McKinney AM. Comparison of CT perfusion summary maps to early diffusion-weighted images in suspected acute middle cerebral artery stroke. European Journal of Radiology. 2015 Apr; 84(4): 682-9. doi: 10.1016/j.ejrad.2014.12.026

Bevers MB, Vaishnav NH, Pham L, Battey TW, Kimberly WT. Hyperglycemia is associated with more severe cytotoxic injury after stroke. Journal of Cerebral Blood Flow & Metabolism. 2017 Jul; 37(7): 2577-83. doi: 10.1177/0271678X16671730

Traenka C, De Marchis GM, Hert L, Seiffge DJ, Polymeris A, Peters N, et al. Acute Ischemic Stroke in Nonconvulsive Status Epilepticus–Underestimated? Results from an Eight-Year Cohort Study. Journal of stroke. 2017 May; 19(2): 236. doi: 10.5853/jos.2016.01669

Rost NS, Bottle A, Lee JM, Randall M, Middleton S, Shaw L, et al. Stroke severity is a crucial predictor of outcome: an international prospective validation study. Journal of the American Heart Association. 2016 Jan; 5(1): e002433. doi: 10.1161/JAHA.115.002433

Bryndziar T, Sedova P, Kramer NM, Mandrekar J, Mikulik R, Brown Jr RD, et al. Seizures following ischemic stroke: frequency of occurrence and impact on outcome in a long-term population-based study. Journal of Stroke and Cerebrovascular Diseases. 2016 Jan; 25(1): 150-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.09.008

Safeer M, Tariq M, Rehman UU. Frequency of risk factors of cerebral infarction in stroke patients: A study of 100 cases in Naseer Teaching Hospital, Peshawar. Pakistan Journal of Medical Sciences. 2008 Jan; 24(1): 109.

Medeiros MJ, Ferreira JP, Leão RB, Sablewski PF, Teixeira FA, Silva KP, et al. Stroke: a retrospective study of gender differences. Journal of the Neurological Sciences. 2015 Oct; 357: e395-6. doi: 10.1016/j.jns.2015.08.1402

Cumming TB, Blomstrand C, Skoog I, Linden T. The high prevalence of anxiety disorders after stroke. The American Journal of Geriatric Psychiatry. 2016 Feb; 24(2): 154-60. doi: 10.1016/j.jagp.2015.06.003

Dorňák T, Král M, Hazlinger M, Herzig R, Veverka T, Buřval S, et al. Posterior vs. anterior circulation infarction: demography, outcomes, and frequency of hemorrhage after thrombolysis. International Journal of Stroke. 2015 Dec; 10(8): 1224-8. doi: 10.1111/ijs.12626

Tu HT, Campbell BC, Christensen S, Desmond PM, De Silva DA, Parsons MW, et al. Worse stroke outcome in atrial fibrillation is explained by more severe hypoperfusion, infarct growth, and hemorrhagic transformation. International Journal of Stroke. 2015 Jun; 10(4): 534-40. doi: 10.1111/ijs.12007

Rinde LB, Småbrekke B, Mathiesen EB, Løchen ML, Njølstad I, Hald EM, et al. Ischemic stroke and risk of venous thromboembolism in the general population: the Tromsø study. Journal of the American Heart Association. 2016 Nov; 5(11): e004311. doi: 10.1161/JAHA.116.004311

Castillo J, Leira R, García MM, Serena J, Blanco M, Dávalos A. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke. 2004 Feb; 35(2): 520-6. doi: 10.1161/01.STR.0000109769.22917.B0

Breschi GL, Mastropietro A, Zucca I, Librizzi L, De Curtis M. Penumbra region excitability is not enhanced acutely after cerebral ischemia in the in vitro isolated guinea pig brain. Epilepsia. 2012 Mar; 53(3): 448-58. doi: 10.1111/j.1528-1167.2011.03356.x

Conrad J, Pawlowski M, Dogan M, Kovac S, Ritter MA, Evers S. Seizures after cerebrovascular events: risk factors and clinical features. Seizure. 2013 May; 22(4): 275-82. doi: 10.1016/j.seizure.2013.01.014

Szaflarski JP, Rackley AY, Kleindorfer DO, Khoury J, Woo D, Miller R, et al. Incidence of seizures in the acute phase of stroke: a population‐based study. Epilepsia. 2008 Jun; 49(6): 974-81. doi: 10.1111/j.1528-1167.2007.01513.x

Hundozi Z, Shala A, Boshnjaku D, Bytyqi S, Rrustemi J, Rama M, et al. Hypertension on admission is associated with a lower risk of early seizures after stroke. Seizure. 2016 Mar; 36: 40-3. doi: 10.1016/j.seizure.2016.01.016

Naylor J, Churilov L, Johnstone B, Guo R, Xiong Y, Koome M, et al. The association between atrial fibrillation and poststroke seizures is influenced by ethnicity and environmental factors. Journal of Stroke and Cerebrovascular Diseases. 2018 Oct; 27(10): 2755-60. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.044

Bladin CF, Alexandrov AV, Bellavance A, Bornstein N, Chambers B, Coté R, et al. Seizures after stroke: a prospective multicenter study. Archives of neurology. 2000 Nov; 57(11): 1617-22. doi: 10.1001/archneur.57.11.1617

Downloads

Published

2023-04-30
CITATION
DOI: 10.54393/pjhs.v4i04.689
Published: 2023-04-30

How to Cite

Gohar Ali, S. . ., Hyder, F. ., Kumari, M. ., Jazil Faruqi, S. ., Abbasi, I. ., & Naeem Shahbaz, N. . (2023). Incidence and Predictors of Acute Symptomatic Seizures After Stroke at A Tertiary Care Hospital: Incidence and Predictors of Acute Symptomatic Seizures. Pakistan Journal of Health Sciences, 4(04), 100–104. https://doi.org/10.54393/pjhs.v4i04.689

Issue

Section

Original Article

Plaudit