Titre
Acute seizures in acute ischemic stroke: does thrombolysis have a role to play?
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Alvarez, V.
Auteure/Auteur
Rossetti, A.O.
Auteure/Auteur
Papavasileiou, V.
Auteure/Auteur
Michel, P.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1432-1459
Statut éditorial
Publié
Date de publication
2013
Volume
260
Numéro
1
Première page
55
Dernière page/numéro d’article
61
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Résumé
Seizures appear at stroke presentation, during the acute phase or as a late complication of stroke. Thrombolysis has not been investigated as a risk factor despite its potential neurotoxic effect. We try to identify risk factors for seizures during the acute phase of ischemic stroke in a cohort including thrombolysed patients. We undertook a case-control study at a single stroke center using data from Acute Stroke Registry and Analyse of Lausanne (ASTRAL). Patients with seizure occurring during the first 7 days following stroke were retrospectively identified. Bi-variable and multivariable statistical analyses were applied to compare cases and randomly selected controls. We identified 28 patients experiencing from seizures in 2,327 acute ischemic strokes (1.2 %). All seizures occurred during the first 72 h. Cortical involvement, thrombolysis with rt-PA, arterial recanalization, and higher initial NIHSS were statistically associated with seizures in univariated analysis. Backward linear regression identified cortical involvement (OR 7.53, 95 % CI 1.6-35.2, p < 0.01) and thrombolysis (OR 4.6, 95 % CI 1.6-13.4, p = 0.01) as being independently associated with seizure occurrence. Overall, 3-month outcome measured by the modified Rankin scale (mRS) was comparable in both groups. In the subgroup of thrombolysed patients, outcome was significantly worse at 3 months in the seizure group with 9/12 (75 %) patients with mRS ≥3, compared to 6/18 (33.3 %) in the seizure-free group (p = 0.03). Acute seizures in acute ischemic stroke were relatively infrequent. Cortical involvement and thrombolysis with rt-PA are the principal risk factors. Seizures have a potential negative influence on clinical outcome in thrombolysed patients.
PID Serval
serval:BIB_65EF067D827E
PMID
Date de création
2013-01-24T16:24:38.246Z
Date de création dans IRIS
2025-05-21T04:32:33Z
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Nom
BIB_65EF067D827E.P001.pdf
Version du manuscrit
postprint
Taille
1.23 MB
Format
Adobe PDF
PID Serval
serval:BIB_65EF067D827E.P001
URN
urn:nbn:ch:serval-BIB_65EF067D827E1
Somme de contrôle
(MD5):3a4937ad03260d3e20add4010b0e2e6e