Subacute Seizure Incidence in Thrombolysis-treated Ischemic Stroke Patients

• Published in: Neurocritical care 2012-04, Vol.16 (2), p.241-245
• Main Authors: Couillard, P., Almekhlafi, M. A., Irvine, A., Jetté, N., Pow, J., St.Germaine-Smith, C., Pillay, N., Hill, M. D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alberta - epidemiology; Atrial Fibrillation - complications; Atrial Fibrillation - mortality; Benzodiazepines; Brain Ischemia - complications; Brain Ischemia - drug therapy; Cardiac arrhythmia; Cardiovascular disease; Chronic obstructive pulmonary disease; Cohort Studies; Convulsions & seizures; Coronary vessels; Critical Care Medicine; Demographics; Epilepsy; Female; Fibrinolytic Agents - therapeutic use; Hemorrhage; Hospitals; Humans; Hypertension; Incidence; Intensive; Internal Medicine; Ischemia; Long term health care; Male; Medicine; Medicine & Public Health; Metabolic disorders; Middle Aged; Mortality; Neurology; Original Article; Patients; Retrospective Studies; Risk Factors; Seizures; Seizures - complications; Seizures - mortality; Stroke; Stroke - complications; Stroke - drug therapy; Stroke - mortality; Substance abuse treatment; thrombolysis; Thrombosis; Tissue Plasminogen Activator - therapeutic use; TPA; Treatment Outcome; Vein & artery diseases
• ISSN: 1541-6933; 1556-0961
• DOI: 10.1007/s12028-011-9657-x

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.