Chao Zhang1, Xiu Wang1, Yao Wang1, Jian-guo Zhang1, Wenhan Hu2, Ming Ge1, Kai Zhang3, Xiaoqiu Shao4. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China. 2. Beijing Neurosurgical Institute, Tiantan xili 6, Dongcheng, Beijing 100050, China. 3. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China. Electronic address: zhangkai62035@163.com. 4. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China. Electronic address: xiaoqiushao@126.com.
Abstract
PURPOSE: To perform a systematic review and meta-analysis to identify risk factors associated with early seizure (ES) or late seizure (LS) onset in adults following stroke. DATA SOURCES: Electronic databases (MEDLINE and EMBASE), archives of stroke or epilepsy patients, and bibliographies of relevant articles, which were written in English. STUDY SELECTION: We included studies published since 1990 that reported the stroke and seizure outcomes of adult patients during follow-up. We independently performed title, abstract and full-text screening and resolved disagreements through discussion. DATA EXTRACTION: Two authors performed the data extraction. We recorded all possible risk factors predictive of seizure onset. DATA SYNTHESIS: We used odds ratios (ORs) or the mean difference (MD) to compare the pooled rates of seizure onset between the exposed group and the non-exposed group. All meta-analyses were performed with Review Manager Software. RESULTS: Intracerebral hemorrhage (OR=1.88, 95% CI=1.43-2.47), cerebral infarction with hemorrhagic transformation (OR=3.28, 95% CI=2.09-5.16), stroke severity (OR=3.10, 95% CI=2.00-4.81, p<0.01, I(2)=0%; MD=3.98, 95% CI=1.06-6.90, p<0.01), and alcoholism (OR=1.70, 95% CI=1.23-2.34, p<0.01) were associated with a significantly greater probability of ES occurrence. There were significant effects of cortical involvement (OR=2.50, 95% CI=1.93-3.23) and stroke severity (MD=5.72, 95% CI=4.23-7.22, p<0.01, I(2)=0) on LS onset. However, there was no significant difference in the probability of single LS episode between patients with intracerebral hemorrhage and infarction stroke (OR=1.20, 95% CI=0.92-1.55). CONCLUSIONS: Evidence suggests that cortical involvement, stroke subtypes and stroke severity are significant predictors of seizure onset following stroke. However, we did not find a significant difference in the rate of onset of single LS episodes between patients with intracerebral hemorrhage and cerebral infarction.
PURPOSE: To perform a systematic review and meta-analysis to identify risk factors associated with early seizure (ES) or late seizure (LS) onset in adults following stroke. DATA SOURCES: Electronic databases (MEDLINE and EMBASE), archives of stroke or epilepsypatients, and bibliographies of relevant articles, which were written in English. STUDY SELECTION: We included studies published since 1990 that reported the stroke and seizure outcomes of adult patients during follow-up. We independently performed title, abstract and full-text screening and resolved disagreements through discussion. DATA EXTRACTION: Two authors performed the data extraction. We recorded all possible risk factors predictive of seizure onset. DATA SYNTHESIS: We used odds ratios (ORs) or the mean difference (MD) to compare the pooled rates of seizure onset between the exposed group and the non-exposed group. All meta-analyses were performed with Review Manager Software. RESULTS:Intracerebral hemorrhage (OR=1.88, 95% CI=1.43-2.47), cerebral infarction with hemorrhagic transformation (OR=3.28, 95% CI=2.09-5.16), stroke severity (OR=3.10, 95% CI=2.00-4.81, p<0.01, I(2)=0%; MD=3.98, 95% CI=1.06-6.90, p<0.01), and alcoholism (OR=1.70, 95% CI=1.23-2.34, p<0.01) were associated with a significantly greater probability of ES occurrence. There were significant effects of cortical involvement (OR=2.50, 95% CI=1.93-3.23) and stroke severity (MD=5.72, 95% CI=4.23-7.22, p<0.01, I(2)=0) on LS onset. However, there was no significant difference in the probability of single LS episode between patients with intracerebral hemorrhage and infarction stroke (OR=1.20, 95% CI=0.92-1.55). CONCLUSIONS: Evidence suggests that cortical involvement, stroke subtypes and stroke severity are significant predictors of seizure onset following stroke. However, we did not find a significant difference in the rate of onset of single LS episodes between patients with intracerebral hemorrhage and cerebral infarction.
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