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Poststroke epilepsy

Johan Zelano
Stroke is among the most common causes of epilepsy after middle age. Patients with poststroke epilepsy (PSE) differ in several respects from patients with other forms of structural-metabolic epilepsy; not least in age, age-related sensitivity to side effects of antiepileptic drugs (AEDs), and specific drug-drug interaction issues related to secondary-stroke prophylaxis. Encouragingly, there has lately been remarkable activity in the study of PSE. Three developments in PSE research deserve particular focus. First, large prospective trials have established the incidence and risk factors of PSE in the setting of modern stroke care...
September 2016: Therapeutic Advances in Neurological Disorders
Doodipala Samba Reddy, Aamir Bhimani, Ramkumar Kuruba, Min Jung Park, Farida Sohrabji
This Review describes the current status of poststroke epilepsy (PSE) with an emphasis on poststroke epileptogenesis modeling for testing new therapeutic agents. Stroke is a leading cause of epilepsy in an aging population. Late-onset "epileptic" seizures have been reported in up to 30% cases after stroke. Nevertheless, the overall prevalence of PSE is 2-4%. Rodent models of stroke have contributed to our understanding of the relationship between seizures and the underlying ischemic damage to neurons. To understand whether acutely generated stroke events lead to a chronic phenotype more closely resembling PSE with recurrent seizures, a limited variety of approaches emerged in early 2000s...
July 25, 2016: Journal of Neuroscience Research
Hyuk Sung Kwon, Chulho Kim, Seung-Hoon Lee, Keun-Hwa Jung, Young Dae Kim, Hyung-Min Kwon, Sung Hyuk Heo, Dae-Il Chang, Beom Joon Kim, Jeong-Min Kim, Hyun Young Kim, Young Seo Kim
BACKGROUND: The incidence of ischemic stroke in young adults has been rising over recent decades, but there is still limited information on its risk factors, etiologies, and outcomes. Because these patients generally participate in social life, risk factors associated with lifestyle may have a great impact and need to be identified. METHODS: The SKY (Stroke in Korean Young Adults) study is a multicenter case-control study and a prospective cohort study in 8 tertiary medical centers in the Republic of Korea...
June 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Chuen-Chau Chang, Ta-Liang Chen, Hsienhsueh Elley Chiu, Chaur-Jong Hu, Chun-Chieh Yeh, Chin-Chuan Tsai, Hsin-Long Lane, Mao-Feng Sun, Fung-Chang Sung, Chien-Chang Liao, Jaung-Geng Lin, Chun-Chuan Shih
ETHNOPHARMACOLOGICAL RELEVANCE: The use of traditional Chinese medicine (TCM) was high in stroke patients but limited information was available on whether TCM is effective on post-stroke outcomes. The aim of this study is to compare the outcomes of stroke patients with and without receiving adjuvant TCM therapy. MATERIALS AND METHODS: Using Taiwan's National Health Insurance Research Database, we conducted a nationwide cohort study and selected hospitalized stroke patients receiving routine care with (n=1734) and without (n=1734) in-hospital adjuvant TCM therapy by propensity score matching procedures...
January 11, 2016: Journal of Ethnopharmacology
Shang-Yi Lee, Chia-Lun Chou, Sanford P C Hsu, Chun-Chuan Shih, Chun-Chieh Yeh, Chih-Jen Hung, Ta-Liang Chen, Chien-Chang Liao
BACKGROUND: Factors associated with poststroke adverse events were not completely understood. The purpose of this study was to investigate whether stroke patients with previous pressure ulcers had more adverse events after stroke. METHODS: Using the claims data from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study matched by propensity score. Three thousand two first-ever stroke patients with previous pressure ulcer and 3002 first-ever stroke patients without pressure ulcer were investigated between 2002 and 2009...
January 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Johan Zelano, Rebecca Gertz Lundberg, Leopold Baars, Emelie Hedegärd, Eva Kumlien
INTRODUCTION: Recently, several epidemiological studies have demonstrated that epilepsy develops after approximately 10% of all cerebrovascular lesions. With an aging population, poststroke epilepsy is likely to be of increasing relevance to neurologists and more knowledge on the condition is needed. Patients with poststroke epilepsy are likely to differ from other epilepsy patient populations regarding age, side-effect tolerability, comorbidities, and life expectancy, all of which are important aspects when counselling newly diagnosed patients to make informed treatment decisions...
September 2015: Brain and Behavior
Jiang Guo, Jian Guo, Jinmei Li, Muke Zhou, Fengqin Qin, Shihong Zhang, Bo Wu, Li He, Dong Zhou
OBJECTIVE: To examine the potential efficacy of statin treatment in reducing the risk of poststroke seizures. METHODS: In this cohort study, patients with a first-ever ischemic stroke and no history of epilepsy before stroke were enrolled. After a mean follow-up period of 2.5 years, a follow-up assessment was performed to identify poststroke epilepsy. Logistic regression and Cox regression analyses were used to assess the relationship between statin use and poststroke early-onset seizures or poststroke epilepsy...
August 25, 2015: Neurology
Antonio Siniscalchi, Scott Mintzer
No abstract text is available yet for this article.
August 25, 2015: Neurology
Heather Wood
No abstract text is available yet for this article.
August 2015: Nature Reviews. Neurology
Renate M Arntz, Loes C A Rutten-Jacobs, Noortje A M Maaijwee, Hennie C Schoonderwaldt, Lucille D A Dorresteijn, Ewoud J van Dijk, Frank-Erik de Leeuw
BACKGROUND AND PURPOSE: Poststroke epilepsy is a common complication after a young stroke. We investigated the association between poststroke epilepsy and mortality. METHODS: We performed a prospective cohort study among 631 patients with a first-ever transient ischemic attack or ischemic stroke, aged 18 to 50 years. Survival analysis and Cox proportional hazard analysis were used to estimate cumulative mortality and hazard ratios for patients with and without epilepsy...
August 2015: Stroke; a Journal of Cerebral Circulation
Sonya M Bierbower, Frank S Choveau, James D Lechleiter, Mark S Shapiro
Cerebral ischemic stroke is a worldwide cause of mortality/morbidity and thus an important focus of research to decrease the severity of brain injury. Therapeutic options for acute stroke are still limited. In neurons throughout the brain, "M-type" K(+) currents, underlain by KCNQ subunits 2-5, play dominant roles in control over excitability, and are thus implicated in myriad neurological and psychiatric disorders. Although KCNQ channel openers, such as retigabine, have emerged as anti-epilepsy drugs, their effects on ischemic injury remain unknown...
February 4, 2015: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Adam Wiśniewski, Barbara Ksiazkiewicz
The most frequent reason of seizures in elderly are vascular diseases of the brain. The early-onset seizures occur in first 7 days after stroke, and the late-onset seizures occur after 7 days after stroke. The aim of the study was to estimate the frequency of seizures in patients who have taken a stand in acute period of stroke, the incidence of seizures in different types of stroke, the frequency of the types of seizures and the risk of death depending on the type of seizure. One hundred and sixty seven patients with ischemic stroke and seizures were enrolled in this retrospective study...
2014: Przegla̧d Lekarski
Zhigang Lei, Hui Zhang, Yanling Liang, Qiliang Cui, Zhiqiang Xu, Zao C Xu
Poststroke seizures are considered to be the major cause of epilepsy in the elderly. The mechanisms of poststroke seizures remain unclear. A history of diabetes mellitus has been identified as an independent predictor of acute poststroke seizures in stroke patients. The present study sought to reveal the mechanisms for the development of postischemic seizures under hyperglycemic conditions. Transient forebrain ischemia was produced in adult Wistar rats by using the four-vessel occlusion method. At the normal blood glucose level, seizures occurred in ∼50% of rats after 25 min of ischemia...
December 2014: Journal of Neuroscience Research
Sophia A Gozzi, Amanda G Wood, Jian Chen, Krishnarao Vaddadi, Thanh G Phan
OBJECTIVE: The purpose of this study was to explore the relationship between lesion location and poststroke depression using statistical parametric mapping. METHODS: First episode patients with stroke were assessed within 12 days and at 1-month poststroke. Patients with an a priori defined cut-off score of 11 on the Hospital Anxiety and Depression Scale (HADS) at follow-up were further assessed using the Mini-International Neuropsychiatric Interview (MINI) to confirm a clinical diagnosis of major or minor depression in accordance with Diagnostic and Statistical Manual-IV (DSM-IV) inclusion criteria...
2014: BMJ Open
Emily Jane Pegg, Fawad Zaman
A 59-year-old man with a background of poststroke epilepsy, lung cancer, chronic obstructive pulmonary disease and hypertension, presented to the medical assessment unit with acute confusion and altered consciousness. Medications included sodium valproate, aspirin and antihypertensives. On examination he was confused, with his Glasgow Coma Scale fluctuating between 10 and 14. Routine blood tests, thyroid function tests, serum sodium valproate level, urine dip, CT of the brain and cerebrospinal fluid analysis were all normal...
2014: BMJ Case Reports
Chen-Shu Chang, Chun-Hui Liao, Che-Chen Lin, Hsien-Yuan Lane, Fung-Chang Sung, Chia-Huang Kao
PURPOSE: Epilepsy is well known as a disorder in poststroke patients. However, studies that have investigated the association between epilepsy and the risk of subsequent stroke are limited. This population-based study investigated the incidence and risk of stroke in patients with epilepsy by using the Taiwan National Health Insurance claims data. METHODS: We identified 3812 patients newly diagnosed with epilepsy in 2000-2008 and 15,248 nonepilepsy comparisons frequency matched according to sex, age, and index year...
May 2014: Seizure: the Journal of the British Epilepsy Association
Chen-Jui Hsu, Wen-Chin Weng, Steven Shinn-Feng Peng, Wang-Tso Lee
BACKGROUND AND PURPOSE: Early-onset seizures are common in children with arterial ischemic stroke, but the clinical features and effects on the outcome of early-onset seizures have been less studied in children. METHODS: Children aged 1 month to 18 years presenting with first-time and image-confirmed arterial ischemic stroke were identified for analysis. RESULTS: A total of 78 survivors of arterial ischemic stroke were enrolled. Twenty (25...
April 2014: Stroke; a Journal of Cerebral Circulation
Yi Luo, Peng-Fei Wu, Jun Zhou, Wen Xiao, Jin-Gang He, Xin-Lei Guan, Jie-Ting Zhang, Zhuang-Li Hu, Fang Wang, Jian-Guo Chen
AIMS: Epileptic seizures are well-known neurological complications following stroke, occurring in 3% of patients. However, the intrinsic correlation of seizures with stroke remains largely unknown. Hydrogen sulfide (H2 S) is a gas transmitter that may mediate cerebral ischemic injury. But the role of H2 S in seizures has not been understood yet. We examined the effect of H2 S on seizure-like events (SLEs) and underlying mechanisms. METHODS AND RESULTS: Pentylenetetrazole (PTZ)- and pilocarpine-induced rat epileptic seizure models were tested...
May 2014: CNS Neuroscience & Therapeutics
Renate M Arntz, Noortje A M Maaijwee, Loes C A Rutten-Jacobs, Hennie C Schoonderwaldt, Lucille D Dorresteijn, Ewoud J van Dijk, Frank-Erik de Leeuw
OBJECTIVE: To determine the influence of poststroke epilepsy on long-term functional outcome in young stroke survivors. METHODS: This study is a prospective cohort study among 537 stroke survivors with a first-ever TIA, ischemic stroke, or intracerebral hemorrhagic (ICH) stroke, aged 18 to 50 years. After a mean follow-up of 9.8 years (SD 8.4), we performed a follow-up assessment that included an evaluation for poststroke epilepsy and functional outcome. Odds ratios for poor outcome on the modified Rankin Scale (mRS) (score >2) and Instrumental Activities of Daily Living (IADL) (score <8) were calculated using logistic regression analysis...
November 26, 2013: Neurology
Christine K Fox, Hannah C Glass, Stephen Sidney, Daniel H Lowenstein, Heather J Fullerton
OBJECTIVE: To determine incidence rates and predictors of epilepsy after childhood stroke and compare these to published estimates of 3 to 5% cumulative epilepsy incidence by 5 years poststroke in adults. METHODS: In a retrospective population-based study of children with stroke (29 days-19 years) in an integrated health care system (1993-2007), poststroke seizures were identified through electronic searches and confirmed by chart review. Stroke and seizure characteristics were abstracted from medical records...
August 2013: Annals of Neurology
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