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Reperfusion therapies and poststroke seizures

Bentes, C. (författare)
Brigo, F. (författare)
Zelano, Johan, 1981 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Ferro, J. M. (författare)
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 (creator_code:org_t)
Elsevier BV, 2020
2020
Engelska.
Ingår i: Epilepsy and Behavior. - : Elsevier BV. - 1525-5050. ; 104
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Seizures are not only a frequent complication of stroke but have been associated with an unfavorable functional and vital outcome of patients who have had stroke. Facing a new paradigm of acute standard stroke care, acute symptomatic seizures in this clinical setting deserve to be rethought. Reperfusion therapies, the gold standard treatment for acute ischemic stroke, improve long-term survival and outcome of patients who have had stroke and have been associated both with clinical seizures and the occurrence of epileptiform activity in the electroencephalogram (EEG). This narrative review describes the different physiopathological mechanisms underlying the possible association between reperfusion therapies and seizures, both acute symptomatic seizures and unprovoked seizures, and the current evidence regarding the risk of poststroke seizures in treated patients. It also identifies the gaps in our knowledge to foster future studies in this field. By different mechanisms, reperfusions therapies may have opposing effects on the risk of poststroke seizures. There is a need for a better definition of the specific physiopathology of seizures in clinical practice, as many factors can be recognized. Additionally, most of the current clinical evidence refers to acute symptomatic seizures and not to unprovoked seizures or poststroke epilepsy, and our analysis does not support the existence of a strong association between thrombolysis and poststroke seizures. So far, the impact of reperfusion therapies on the frequency of poststroke seizures is unclear. To study this effect, many clinical challenges must be overcome, including a better and clear operational definition of seizures and stroke characteristics, the standard of stroke and epilepsy care and EEG monitoring, and the degree of reperfusion success. Prospective, high quality, larger, and longer follow-up multicentric studies are urgently needed. Additionally, stroke registries can also prove useful in better elucidate whether there is an association between reperfusion therapies and seizures. Seizures & Stroke. © 2019 Elsevier Inc.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

Nyckelord

Acute symptomatic seizures
Epilepsy
Reperfusions therapies
rtPA
Stroke
Thrombolysis
Unprovoked seizures

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Av författaren/redakt...
Bentes, C.
Brigo, F.
Zelano, Johan, 1 ...
Ferro, J. M.
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MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Medicinska och f ...
och Neurovetenskaper
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Epilepsy and Beh ...
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Göteborgs universitet

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