A Study on Acute Symptomatic Seizures Following Stroke in a Tertiary Care Centre
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 7
Abstract
IM: To study the clinical and etiological profile of 130 consecutive patients with acute symptomatic seizures following stroke presenting to a tertiary care centre in south India. BACKGROUND: Post stroke seizures are defined as those at the beginning of or after stroke in a patient without prior onset of seizures. They are classified as acute symptomatic seizures(ASS) and Unprovoked seizures(US) depending on the time of occurrence with respect to the onset of stroke.The ILAE defines ASS if they occur within 7 days of stroke and US if seizures manifest after 1 week.Semiology could be focal seizures,focal with secondary generalization and generalized tonic clonic seizures. MATERIALS AND METHODS:130 consecutive patients with acute symptomatic seizures admitted in the Department of Neurology, Madras Medical College were included in the study after obtaining informed consent.After enrolment into the study based on the inclusion and exclusion criteria,a pre designed questionnaire was filled with information regarding demographic details,clinical features,type and size of stroke based on imaging and EEG patterns.RESULTS:Mean age of all patients was 52.4 years ranging from 32 years to 86 years.Out of 130 patients 93 were males and 37 were females .97 patients had seizures within the first 24 hours.86(66%) patients had ischemic stroke, out of which 65 were cortical and 21 were subcortical.Total of 33(26%) patients had ICH -14 had lobar haemorrhage and 19 had ganglionic bleed.11(8%) patients had cerebral infarct with hemorrhagic transformation. With regard to semiology of seizures 72(55%) had focal,40(31%) had focal with secondary generalisation,13(10%) had generalised tonic clonic seizures and 5(4%) had status epilepticus.EEG recordings were normal in 44(34%) patients,showedfocal slowing in 38(29%),diffuse slowing in 32(25%) and epileptiform discharges in 16(12%) patients.Out of the total 130 patients 52(40%) had single seizures and 78(60%) had multiple seizures.Only 4(3%) out of 130 patients had recurrent seizures. CONCLUSION: In our study patients with ischemic stroke presented with acute symptomatic seizures more commonly compared to ischemic stroke with hemorrhagic transformation and Intracerebral hemorrhage .Cortical site and larger size had more percentage of seizures compared to the subcortical site and smaller size in both ischemic and hemorrhagic stroke.Focal seizures with or without secondary generalization were found to be the commonest semiology. However there was no specific EEG pattern correlating to recurrence of seizures nor did it make any difference to the management of the patient.
Authors and Affiliations
Dr Shubha Subramanian, Dr V Chandramouleeswaran, Dr Kannan V, Dr Lakshmi Narasimhan
Keywords
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- EP ID EP378502
- DOI 10.9790/0853-1707131417.
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