Sara Gasparini1, Michele Ascoli1, Francesco Brigo2, Vittoria Cianci3, Damiano Branca3, Luciano Arcudi3, Umberto Aguglia4, Vincenzo Belcastro5, Edoardo Ferlazzo1. 1. Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy; Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy. 2. Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Hospital Franz Tappeiner, Department of Neurology, Merano, Italy. 3. Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy. 4. Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy; Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy. Electronic address: u.aguglia@gmail.com. 5. Neurology Unit, S. Anna Hospital, Como, Italy.
Abstract
AIMS: Stroke is the most commonly identified cause of late-onset epilepsy. Risk factors for poststroke epilepsy (PSE) are partially elucidated, and many studies have been performed in recent years. We aimed to update our previous systematic review and meta-analysis on risk factors for PSE. METHODS: PubMed, Google Scholar, and Scopus databases were searched. Articles published in English (1987-2019) were included. Odds ratios (OR) and mean values were calculated for examined variables. RESULTS: Thirty studies with different designs were included, enrolling 26,045 patients who experienced stroke, of whom 1800 had PSE, corresponding to a prevalence of 7%. Cortical lesions (OR: 3.58, 95% confidence interval (CI): 2.35-5.46, p < 0.001), hemorrhagic component (OR: 2.47, 95% CI: 1.68-3.64, p < 0.001), early seizures (ES) (OR: 4.88, 95% CI: 3.08-7.72, p < 0.001), and younger age at stroke onset (difference in means: 2.97 years, 95% CI: 0.78 to 5.16, p = 0.008) favor PSE. Sex and acute treatment with recombinant tissue plasminogen activator (rtPA) do not predict the occurrence of PSE. CONCLUSION: Despite limitations due to the uneven quality and design of the studies, the present meta-analysis confirms that cortical involvement, hemorrhagic component, and ES are associated with a higher risk of PSE. In this update, younger age at stroke onset but not thrombolytic treatment seems to increase the risk for PSE. This article is part of the Special Issue "Seizures & Stroke".
AIMS: Stroke is the most commonly identified cause of late-onset epilepsy. Risk factors for poststroke epilepsy (PSE) are partially elucidated, and many studies have been performed in recent years. We aimed to update our previous systematic review and meta-analysis on risk factors for PSE. METHODS: PubMed, Google Scholar, and Scopus databases were searched. Articles published in English (1987-2019) were included. Odds ratios (OR) and mean values were calculated for examined variables. RESULTS: Thirty studies with different designs were included, enrolling 26,045 patients who experienced stroke, of whom 1800 had PSE, corresponding to a prevalence of 7%. Cortical lesions (OR: 3.58, 95% confidence interval (CI): 2.35-5.46, p < 0.001), hemorrhagic component (OR: 2.47, 95% CI: 1.68-3.64, p < 0.001), early seizures (ES) (OR: 4.88, 95% CI: 3.08-7.72, p < 0.001), and younger age at stroke onset (difference in means: 2.97 years, 95% CI: 0.78 to 5.16, p = 0.008) favor PSE. Sex and acute treatment with recombinant tissue plasminogen activator (rtPA) do not predict the occurrence of PSE. CONCLUSION: Despite limitations due to the uneven quality and design of the studies, the present meta-analysis confirms that cortical involvement, hemorrhagic component, and ES are associated with a higher risk of PSE. In this update, younger age at stroke onset but not thrombolytic treatment seems to increase the risk for PSE. This article is part of the Special Issue "Seizures & Stroke".
Authors: Johann Philipp Zöllner; Friedhelm C Schmitt; Felix Rosenow; Konstantin Kohlhase; Alexander Seiler; Adam Strzelczyk; Hermann Stefan Journal: Neurol Res Pract Date: 2021-12-06
Authors: Carolina Ferreira-Atuesta; Nico Döhler; Barbara Erdélyi-Canavese; Ansgar Felbecker; Philip Siebel; Natalie Scherrer; Giulio Bicciato; Juliane Schweizer; Lucia Sinka; Lukas L Imbach; Mira Katan; Laura Abraira; Estevo Santamarina; José Álvarez-Sabín; Michael Winklehner; Tim J von Oertzen; Judith N Wagner; Gian Luigi Gigli; Anna Serafini; Francesco Janes; Giovanni Merlino; Mariarosaria Valente; Giorgia Gregoraci; Julian Conrad; Stefan Evers; Piergiorgio Lochner; Frauke Roell; Francesco Brigo; Carla Bentes; Ana Rita Peralta; Teresa Pinho E Melo; Mark R Keezer; John S Duncan; Josemir W Sander; Barbara Tettenborn; Matthias J Koepp; Marian Galovic Journal: Ann Neurol Date: 2021-09-30 Impact factor: 11.274