Sackler Medical School, Tel-Aviv University, Israel.
Neurological department, Kaplan Medical Center, Rechovot, Israel; Hebrew university, Jerusalem, Israel.
Seizure. 2018 Nov;62:91-94. doi: 10.1016/j.seizure.2018.09.001. Epub 2018 Sep 14.
Post stroke seizures are a complication that occur in 5-20% of acute ischemic stroke (AIS) patients, cause a reduction in quality of life and a greater burden on the health system. There is not enough data regarding an association between today's standard of care treatment in AIS: recombinant tissue plasminogen activator (r-tPA) and the risk for post stroke seizures. Our aim in this work is to reveal such a connection.
A non-randomized retrospective cohort-controlled study of 234 patients, who were hospitalized with acute ischemic stroke at Kaplan Medical Center in the years 2009-2015 and were divided into two different treatment groups: r-tPA and antiaggregant therapy(n = 141) and antiaggregant therapy only (n = 95) was conducted by us. Information regarding demographics, medical history, nature of the event, including NIHSS values on admission, discharge, and post stroke seizures, were obtained for each group. Follow-up was done for one year.
During the year of follow-up, 19 patients (8.1%) of the overall cohort, developed seizures: 12 of them (12.6%) belonged to the control group and 7 (5%) to the study group p < 0.05). Results showed a decrease in the risk for developing seizure when treated with r-tpA, comparing to antiaggregants (odds ratio = 0.64).
This study suggests there is an association between r-tPA treatment and reduction of the risk for post stroke seizures.
脑卒中后癫痫是一种并发症，发生在 5-20%的急性缺血性脑卒中（AIS）患者中，降低生活质量并给医疗系统带来更大负担。目前关于 AIS 标准治疗（重组组织型纤溶酶原激活剂[r-tPA]）与脑卒中后癫痫风险之间的关联，数据还不够充分。我们旨在揭示这两者之间的联系。
我们对 2009 年至 2015 年在卡普兰医学中心住院的 234 名急性缺血性脑卒中患者进行了一项非随机回顾性队列对照研究，将他们分为 r-tPA 和抗血小板治疗（n=141）和仅抗血小板治疗（n=95）两组。我们获取了每组患者的人口统计学、病史、发病性质等信息，包括入院、出院和脑卒中后 NIHSS 值，以及癫痫发作情况。对所有患者进行为期一年的随访。
在一年的随访期间，共有 19 名患者（8.1%）出现癫痫发作：其中对照组 12 名（12.6%），研究组 7 名（5%），p<0.05）。结果表明，与使用抗血小板药物相比，r-tpA 治疗可降低癫痫发作风险（比值比=0.64）。
本研究表明 r-tPA 治疗与脑卒中后癫痫发作风险降低之间存在关联。
