Subacute seizure incidence in thrombolysis-treated ischemic stroke patients

Neurocrit Care. 2012 Apr;16(2):241-5. doi: 10.1007/s12028-011-9657-x.

Abstract

Background: To assess the incidence of seizures in acute ischemic stroke patients treated with chemical (tPA) thrombolysis.

Methods: Retrospective study including all thrombolysis patients treated in Calgary between January 1, 2001, and October 31, 2006. Descriptive statistics and age/sex-adjusted P values were calculated.

Results: Of 400 eligible patients (median age 74.0 years, range: 24-77), 16 (4%) developed post-stroke seizures: 10 (62.5%) within one week (early) and 6 (37.5%) after 1 week but within the hospital stay (late). Single-vessel anterior circulation involvement (93.8% vs. 87%, P = 0.34) and hemorrhage (37.5% vs. 20%, P = 0.15) were more common in those with compared to without seizures but did not reach statistical significance. Atrial fibrillation was more common in those with (56.3%) than without (36.1%) seizures (P = 0.04). Death during admission was more likely (P = 0.03) in those who sustained seizures (37.5%) compared to those without seizures (17.6%).

Conclusions: In this cohort of tPA-treated patients, post-stroke seizures were associated with atrial fibrillation and early mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alberta / epidemiology
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / mortality
  • Brain Ischemia / complications*
  • Brain Ischemia / drug therapy
  • Cohort Studies
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Seizures / complications*
  • Seizures / mortality
  • Stroke / complications
  • Stroke / drug therapy
  • Stroke / mortality*
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator