Wednesday, February 28, 2024

Outcomes and Predictors of Seizure Recurrence in Post-Stroke Epilepsy, A Retrospective Hospital-based Study

 Predicting post stroke epilepsy rather than preventing it is the HEIGHT OF STUPIDITY! And you're still employed in stroke? Look how long we've known of the problem.

Just maybe you want your doctor to try these solutions.


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Or maybe the nasal spray referred to in here:

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 The latest here:

Outcomes and Predictors of Seizure Recurrence in Post-Stroke Epilepsy, A Retrospective Hospital-based Study

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https://doi.org/10.1016/j.clineuro.2024.108208Get rights and content

Highlights

  • Recurrence in Post-Stroke seizure (PSS) is associated with significant functional decline in stroke patients.

  • Choice of anti-seizure medications (ASMs) may influence the morbidity and mortality.

  • Future research is needed to explore the effects of ASMs on PSS pathophysiology.

Abstract

Background

The occurrence of seizures following a stroke is a well-recognized complication associated with a significant increase in morbidity and mortality. Despite the numerous studies examining outcomes and risk factors related to post-stroke seizures (PSS), there remains a lack of clarity(And you incompetently didn't create a protocol on how to prevent this problem?)  regarding the clinical characteristics, treatment, and PSS recurrence (PSSR) rates in patients experiencing their initial episode of PSS.

Purpose

This study aimed to determine the risk factors for developing recurrent seizures after first PSS and their effects on functional outcomes and mortality.

Methods

All patients underwent an electroencephalography (EEG) and were monitored for a minimum of 24 months following the first PSS. The primary endpoint was the recurrence of seizures. Predictive factors for PSSR were determined by using the Cox-proportional hazards model, and the cumulative latency of recurrence at 90, 180, 360, and 720 days was estimated using Kaplan-Meier analysis.

Results

Seizure recurred in 36.8% (39/106). Significant association of PSSR was noted with female gender, use of older anti-seizure medications (ASMs) (p<0.001), EEG findings as focal slow wave activity (p<0.001), Ictal epileptiform abnormalities (p=0.015), status epilepticus (p=0.015), and with severe disability (p=0.008). However, multivariate cox-proportional hazards model showed significant association of female gender (HR=3.28; 95% CI: 1.42-7.58; p=0.006). Hazard ratio (HR) was increased with older ASMs use, focal aware seizure types, Ictal EAs, and periodic discharges on EEG; though, statistically significant.

Conclusion

Factors such as the type of ASMs, EEG findings, and seizure type were significantly linked to PSSR. Female gender was the only independent predictor established. Additionally, significant functional decline was reported with recurrence.

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