Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
Neurophysiology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Seizure. 2019 Jul;69:193-197. doi: 10.1016/j.seizure.2019.04.022. Epub 2019 May 1.
The risk of developing epilepsy at long term after post-stroke status epilepticus (PSSE) is unknown. We aimed to evaluate post-stroke epilepsy (PSE) after early-onset PSSE and its associated factors.
All consecutive patients with early-onset PSSE and no history of epilepsy admitted to our hospital between February 2011 and April 2017 were included. We analysed status epilepticus (SE) and stroke-related factors in relation to the development of PSE.
Fifty patients with early-onset PSSE were analysed. Mean age was 74.8 ± 14.3 years and 22 (44%) were women. Median NIHSS at the onset of PSSE was 11 (IQR 4-16) and median PSSE duration was 12 h (IQR 4.69-57). Median follow-up was 214 days (IQR 7.5-747). Ten patients (20%) developed PSE at a median delay of 153 days (IQR 20-334). On multivariate analysis, NIHSS > 4 (p = 0.019; hazard ratio: 15.757; 95% CI, 1.564-158.799) and PSSE > 16 h (p = 0.023; hazard ratio: 7.483; 95% CI, 1.325-42.276) were independently associated with a greater risk of PSE. The mean time from PSSE to onset of recurrent seizures was 142 days (IQR 19-153) in patients with PSSE > 16 h and 310 days (IQR 147-480) in PSSE < 16 h (p = 0.094).
NIHSS score >4 at the stroke presentation and PSSE duration >16 h may predict of PSE in patients with early-onset PSSE. Recurrence may develop earlier in PSSE patients with longer duration of the episode.
脑卒中后癫痫持续状态（PSSE）后长期发生癫痫的风险尚不清楚。我们旨在评估早发性 PSSE 后癫痫发作（PSE）及其相关因素。
纳入 2011 年 2 月至 2017 年 4 月间我院收治的所有早发性 PSSE 且无癫痫病史的连续患者。我们分析了癫痫持续状态（SE）和与中风相关的因素与 PSE 发生的关系。
分析了 50 例早发性 PSSE 患者。平均年龄为 74.8±14.3 岁，22 例（44%）为女性。PSSE 发作时 NIHSS 中位数为 11（IQR 4-16），PSSE 持续时间中位数为 12 小时（IQR 4.69-57）。中位随访时间为 214 天（IQR 7.5-747）。10 例（20%）患者在中位延迟 153 天后（IQR 20-334）发生 PSE。多变量分析显示，NIHSS>4（p=0.019；危险比：15.757；95%CI，1.564-158.799）和 PSSE>16 小时（p=0.023；危险比：7.483；95%CI，1.325-42.276）与 PSE 风险增加独立相关。PSSE>16 小时的患者从 PSSE 到复发性癫痫发作的平均时间为 142 天（IQR 19-153），PSSE<16 小时的患者为 310 天（IQR 147-480）（p=0.094）。
脑卒中发作时 NIHSS 评分>4 和 PSSE 持续时间>16 小时可能预测早发性 PSSE 患者的 PSE。发作持续时间较长的 PSSE 患者复发可能更早。
