Onder Halil, Arsava Ethem Murat, Topcuoglu Mehmet Akif, Dericioglu Nese
1 Hacettepe University Faculty of Medicine, Ankara, Turkey.
Clin EEG Neurosci. 2017 Nov;48(6):417-421. doi: 10.1177/1550059417727225. Epub 2017 Aug 28.
Ischemic or hemorrhagic stroke are among the most common causes of seizures, especially in the elderly. EEG is the only technique that can detect epileptiform abnormalities (EA) and nonconvulsive status epilepticus (NCSE), which may negatively affect recovery of these patients. Herein we aimed to investigate the potential predictive value of long-term EEG findings in terms of poststroke seizures (PSS) and survival, in stroke patients followed up in the neurological intensive care unit (NICU).
Video-EEG reports of stroke patients (ischemic and hemorrhagic) hospitalized between 2009 and 2014 in our NICU were reviewed. Patients with <2 months of survival were excluded. Follow-up data were obtained via telephone calls or patient charts. The correlation between EEG findings and early (≤1 week) and late seizure (>1 week) occurrence, recurrent seizure development, outcome, and survival were analyzed statistically.
Overall 50 patients (27 female, 23 male; age, 26-85 years) were included in the final analysis. Almost 60% developed PSS (~2/3 were early). There was no difference between ischemic versus hemorrhagic stroke patients ( P = .72). Recurrent seizures were more common in the late seizure group ( P < .001). EAs occurred in one-third of the study cohort. This finding did not predict seizure development ( P = .93) or survival ( P = .61).
PSS are a frequent finding in stroke patients followed up in NICU. EAs are not uncommon, but do not predict seizure occurrence or survival.
缺血性或出血性卒中是癫痫发作最常见的原因之一，尤其是在老年人中。脑电图（EEG）是唯一能够检测癫痫样异常（EA）和非惊厥性癫痫持续状态（NCSE）的技术，而这些情况可能会对这些患者的恢复产生负面影响。在此，我们旨在研究在神经重症监护病房（NICU）接受随访的卒中患者中，长期EEG结果对卒中后癫痫（PSS）和生存的潜在预测价值。
回顾了2009年至2014年在我们NICU住院的卒中患者（缺血性和出血性）的视频EEG报告。排除生存时间<2个月的患者。通过电话或患者病历获取随访数据。对EEG结果与早期（≤1周）和晚期癫痫发作（>1周）的发生、癫痫复发、结局和生存之间的相关性进行统计学分析。
最终分析纳入了50例患者（27例女性，23例男性；年龄26 - 85岁）。近60%的患者发生了PSS（约2/3为早期发作）。缺血性与出血性卒中患者之间无差异（P = 0.72）。癫痫复发在晚期癫痫发作组中更为常见（P < 0.001）。EA出现在三分之一的研究队列中。这一发现并未预测癫痫发作的发生（P = 0.93）或生存情况（P = 0.61）。
在NICU接受随访的卒中患者中，PSS是常见现象。EA并不罕见，但不能预测癫痫发作的发生或生存情况。
