ACUTE SYMPTOMATIC SEIZURES AT THE NEW-ONSET OF ISCHEMIC STROKE. СLINICAL AND PATHOGETENIC ASPECTS
Abstract
INTRODUCTION. Acute symptomatic seizures (ASS) are also known as situation-related seizures — a term recommended by experts of the International League against Epilepsy (ILAE, 2010) aiming to define clinical seizures occurring in close temporal relationship with an acute central nervous system stroke. Such seizures are considered to be an acute manifestation of the stroke and may not recur when the underlying cause has been removed or the acute phase is over
OBJECT. To develop clinical and neurological criteria for the differential diagnosis of epileptic seizures from ASS at the onset of ischemic stroke.
METHODS. 72 patients with ischemic stroke hospitalized in the regional vascular center on the basis of the SPb State Budget Healthcare Institution “Municipal Hospital of the Saint Martyr Elizabeth“ in the period from 12.24.2017 to 04.05.2019. All patients were examined by neurological examination, laboratory and radiological research methods, the history of the disease and life was studied. Statistical analysis was performed using IBM SPSS Statistics v.24.
RESULTS. 47 people made up a group with a confirmed diagnosis of an ASS at the onset of ischemic stroke and 25 patients with ischemic stroke without acute symptomatiс seizures.Incidence of ASS at the onset of ischemic stroke was 1.55% (47 patients out of 3024 with ischemic stroke), of them, 55.3% of patients had only seizures, 17.0% had seizures combined with weakness of extremities, 8.5% had a combination of seizures with speech disorder and in 19.1% — a combination of all three signs. Primary risk factors for ASS for patients with ischemic stroke are: cardioembolic stroke subtype (34%) and cortical localization on CT of the lesion (21.4%).
CONCLUSIONS. The frequency of acute symptom seizures in the debut of ischemic stroke is lower in strokes as a whole, but seizures was dominated in the neurological status. The main risk factors for acute symptom attacks in patients with ischemic stroke were cardioembolic stroke subtype and cortical localization of the focus.
The developed algorithm of examination of patients with acute symptom attacks in the debut of AI was necessary for the optimization of management tactics when entering the hospital.
About the Authors
T. V. SergeevaRussian Federation
V. Koriakovskiy
Russian Federation
G. Odintsova
Russian Federation
Yu. A. Shcherbuk
Russian Federation
D. Yu. Butko
Russian Federation
References
1. Povzun AA, Schugareva LM, Iova AS. Increasing of assessment effectiveness of neurological evaluation in detection traumatic intracranial injures in children with clinical criteria of mild traumatic brain injury. Pediatr. 2018; 9(3):28–34.] https://doi.org/10.17816/PED9328–33
2. Fomina M. Yu., Melashenko T. V., Pavlova O. I. Neonatal convulsions in full-term newborns: clinical and electrophysiological features. Pediatr. 2018; 9(5):13–21]
3. Beghi E, Carpio A, Forsgren L, Hesdorffer DC, Malmgren K, Sander JW, Tomson T, Hauser WA. Recommendation for a definition of acute symptomatic seizure. Epilepsia. 2010;51(4):671–5. https:// doi.org/10.1111/j.1528–1167.2009.02285.x.
4. Beleza P. Acute symptomatic seizures: a clinically oriented review. Neurologist. 2012;18(3):109–19. https://doi.org/10.1097/NRL.0b013e318251e6c3.
5. Halawa I. 2017. Acute Symptomatic Seizures. Clinical and Experimental Studies. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1298. 52 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN978–91–554–9812–2.
6. Vaichene-Magistries, N. Acute symptomatic seizures. Epilepsiya i paroksizmalnye sostoyaniya. 2011;3(4):42–44.]
7. Szaflarski JP, Rackley AY, Kleindorfer DO, Khoury J, Woo D, Miller R, Alwell K, Broderick JP, Kissela BM. Incidence of seizures in the acute phase of stroke: A population-based study. Epilepsia. 2008;49(6):974–81. https://doi.org/10.1111/j.1528–1167.2007.01513.x
8. Savello A. V., Svistov D. V., Sorokoumov V. A. Endovascular treatments for ischemic stroke: Present status and prospects. Nevrologiia. Neiropsikhiatriia. Psikhosomatika. 2015;7(4):42–49. (In Russ.)] https://doi.org/10.14412/2074–2711–2015–4–42–49
9. Kleindorfer DO; Demaerschalk BM, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, Khalessi AA, Levy EI, Palesch YY, Prabhakaran S, Saposnik G, Saver JL, Smith EEScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016;47:581–641. https://doi.org/10.1161/STR.0000000000000086
10. Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, OrtegaGutierrez S, McTaggart RA, Torbey MT, Kim-Tenser M, LeslieMazwi T, Sarraj A, Kasner SE, Ansari SA, Yeatts SD, Hamilton S, Mlynash M, Heit JJ, Zaharchuk G, Kim S, Carrozzella J, Palesch YY, Demchuk AM, Bammer R, Lavori PW, Broderick JP, Lansberg MG. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med. 2018;378(8):708–718. https://doi.org/10.1056/NEJMoa1713973.
11. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018;49(3):46–110. https://doi.org/10.1161/STR.0000000000000158
12. Hesdorffer DC, Benn EK, Cascino GD, Hauser WA. Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure. Epilepsia. 2009; 50(5):1102–8. https://doi.org/10.1111/j.1528–1167.2008.01945.x
13. Ivanova N. E., Ivanov A. Ju., Odincova G. V., Olejnik A. A., Olejnik E. A.STRUKTURA PAROKSIZMAL′NOGO SINDROMA PRI NEJROHIRURGIChESKOJ CEREBROVASKULJАRNOJ PATOLOGII. // Ros. n/h zhurnal im. prof. A. L. Polenova. — S. 97. (Sb. materialovXVII Vseros. nauch.-prakt. konf. «Polenovskie chtenija». SPb., 23–25.04. 2018) (In Russ.)]
14. Odintsova G. V., Aleksandrov M. V., Ulitin A. Y., Koloteva A. V. Duration of epilepsy and severity of the disease in neurosurgical patients. Epilepsy and paroxysmal conditions. 2018;10(3):44–51. (In Russ.) https://doi.org/10.17749/2077–8333.2018.10.3.044–051]
Review
For citations:
Sergeeva T.V., Koriakovskiy V., Odintsova G., Shcherbuk Yu.A., Butko D.Yu. ACUTE SYMPTOMATIC SEIZURES AT THE NEW-ONSET OF ISCHEMIC STROKE. СLINICAL AND PATHOGETENIC ASPECTS. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2019;11(3):38-43. (In Russ.)