Cardiogenic cerebral infarction in the parietal lobe predicts the development of post-stroke epilepsy
| Autor: | Kei-ichiro Takase |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Infarction Epileptogenesis 03 medical and health sciences Epilepsy 0302 clinical medicine Parietal Lobe Internal medicine polycyclic compounds medicine Humans cardiovascular diseases Stroke Retrospective Studies Cerebral infarction business.industry Parietal lobe Atrial fibrillation Cerebral Infarction General Medicine biochemical phenomena metabolism and nutrition medicine.disease Neurology Cardiology Neurology (clinical) Epileptic seizure medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Seizure. 80:196-200 |
| ISSN: | 1059-1311 |
| DOI: | 10.1016/j.seizure.2020.06.018 |
| Popis: | Post-stroke epilepsy (PSE) is a major late complication of cardioembolic cerebral infarction. However, few studies have examined the epileptogenicity and characteristics of first-occurrence cardioembolic cerebral infarctions.This retrospective study included 93 consecutive patients with old cardioembolic cerebral infarctions who were classified into two groups based on their epileptic history: patients presenting with PSE or stroke without seizure (SWS). Each patient was diagnosed with an epileptic seizure subtype and treated with appropriate anti-epileptic therapy after admission. We evaluated clinical characteristics, laboratory results, and intracranial infarct areas. The sizes of these areas were measured using MRI diffusion-weighted image (DWI) of each patient after their first stroke. The volume was calculated by multiplying the total slice area with the slice thickness.PSE was diagnosed in 43 (46.2 %) of 93 patients. The mean (± SD) time from infarction onset to the first seizure in the PSE group was 22.5 ± 31.6 months. The PSE group exhibited significantly more atrial fibrillation (p = 0.022) and higher glucose levels (p 0.001) compared with the SWS group. The most common PSE seizure type was focal to bilateral tonic-clonic seizure (61.0 %). Although DWI did not reveal any significant differences in the volume of infarctions between the two groups, the involvement of the parietal lobe in infarction of the PSE group (69.8 %) upon first admission was significantly higher (p = 0.006) than that of the SWS group (40.0 %). Multiple logistic regression analysis revealed that parietal lobe involvement in infarction (OR 4.95; 95 % CI 1.25-19.60; p = 0.023) was a significant independent predictor of PSE.The involvement of the parietal lobe in infarction was a significant independent predictor of PSE. Dysfunction of the parietal lobe might play a critical role in the epileptogenesis of PSE. |
| Databáze: | OpenAIRE |
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