Research progress on epilepsy after reperfusion therapy in ischemic stroke
10.3969/j.issn.1002-0152.2024.10.010
- VernacularTitle:缺血性卒中再灌注治疗后癫痫的研究进展
- Author:
Yue LIU
1
,
2
;
Shuda CHEN
;
Siqing CHEN
;
Xinxin PENG
;
Sijing YIN
;
Dingju LONG
;
Chengzhe WANG
;
Xintong GUO
;
Guanzhong NI
;
Ziyi CHEN
Author Information
1. 中山大学附属第一医院神经科,广东省重大神经疾病诊治研究重点实验室,国家临床重点专科和国家重点学科(广州 510080)
2. 中山大学附属第七医院神经医学中心
- Keywords:
Ischemic stroke;
Reperfusion;
Acute symptomatic seizures;
Epilepsy;
Intravenous thrombolysis;
En-dovascular thrombectomy
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(10):619-626
- CountryChina
- Language:Chinese
-
Abstract:
There is no unified international guidelines or consensus on seizures and epilepsy following acute stroke reperfusion therapy so far.In this review,we briefly summarize its definitions and mechanisms.Post stroke epilepsy after reperfusion treatment is defined as patients with ischemic stroke who have received intravenous thrombolysis and/or endovascular therapy,without other definitive causes or epilepsy history before stroke,have at least two epileptic seizures occurred within 7 days of stroke onset,or at least one epileptic seizures occurred within 30 days of stroke onset.The incidence rate of epilepsy after intravenous thrombolysis is about 6.4%-20.6%,and arterial thrombectomy is about 5%.The pathophysiological mechanism of post stroke epilepsy after reperfusion treatment may be related to local hyperfusion,epileptogenic properties of tPA and hemorrhagic transformation.Higher stroke severity,cortical involvement,middle cerebral artery infarction,and early post-stroke seizures may be predictive factors for post-stroke epilepsy after reperfusion therapy.Levetiracetam and lamotrigine may be effective drugs for post-stroke epilepsy after reperfusion therapy.Sustained seizures after thrombolysis may increase the risk of death.
