Clinical and imaging features of nonmotor onset seizure in poststroke epilepsy.

Autor: Fukuma K; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan., Ikeda S; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan., Tanaka T; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan., Kamogawa N; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Ishiyama H; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan., Abe S; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan., Tojima M; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Kobayashi K; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Shimotake A; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Nakaoku Y; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan., Nishimura K; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan., Koga M; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Toyoda K; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan., Matsumoto R; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan., Ikeda A; Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Ihara M; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2022 Aug; Vol. 63 (8), pp. 2068-2080. Date of Electronic Publication: 2022 Jun 10.
DOI: 10.1111/epi.17308
Abstrakt: Objective: Motivated by the challenges raised by diagnosing poststroke epilepsy (PSE), especially in nonmotor onset seizure (non-MOS), we aimed to investigate the features of non-MOS, including seizure sequences, patient characteristics, and electrophysiological and imaging findings in PSE.
Methods: This observational cohort study enrolled patients with PSE whose seizure onset was witnessed. According to the International League Against Epilepsy (ILAE) 2017 seizure classification, we classified seizure-onset symptoms into the non-MOS and MOS groups. We compared the different clinical characteristics between the two groups.
Results: Between 2011 and 2018, we enrolled 225 patients with PSE (median age, 75 years), consisting of 97 (43%) with non-MOS and 128 (57%) with MOS. Overall, 65 (67%) of the patients without MOS had no subsequent convulsions. Multivariable logistic regression analysis showed significant associations of non-MOS with absence of poststroke hemiparesis (adjusted odds ratio [OR], 1.88; 95% confidence interval [CI], 1.03-3.42), frontal stroke lobe lesions (OR, 2.11; 95% CI, 1.14-3.91), and putaminal stroke lesions (OR, 2.51; 95% CI, 1.22-5.18) as negative indicators. Postictal single-photon emission computed tomography (SPECT) detected prolonged hyperperfusion in the temporal lobe more frequently in the non-MOS than in the MOS group (48% vs 31%; p = .02). The detection rate was higher than spikes/sharp waves in scalp electroencephalography, both in the non-MOS group (72% vs 33%; p < .001) and the MOS group (68% vs 29%; p < .001).
Significance: This study provides the clinical features of non-MOS in patients with PSE. Compared with the patients with MOS, patients with non-MOS showed less likely subsequent convulsive seizures, highlighting the clinical challenges. Postictal perfusion imaging and negative indicators of the non-MOS type may help diagnose and stratify PSE.
(© 2022 International League Against Epilepsy.)
Databáze: MEDLINE
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