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J Neurol. 2018 Aug;265(8):1780-1788. doi: 10.1007/s00415-018-8907-7. Epub 2018 May 29.

The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study.

Author information

1
Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
2
Department of Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
3
School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands.
4
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
5
Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe Center of Expertise for Epileptology, Maastricht, The Netherlands.
6
Faculty of Electrical Engineering, University of Technology, Eindhoven, The Netherlands.
7
Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. R.Rouhl@mumc.nl.
8
School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands. R.Rouhl@mumc.nl.
9
Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe Center of Expertise for Epileptology, Maastricht, The Netherlands. R.Rouhl@mumc.nl.

Abstract

OBJECTIVE:

Epileptic seizures are a common complication after stroke. The relation between occurrence of seizures after stroke and long-term mortality remains elusive. We aimed to assess whether seizures in an early or late phase after ischemic stroke are an independent determinant of long-term mortality.

METHODS:

We prospectively included and followed 444 ischemic stroke patients with a first-ever supratentorial brain infarct for at least 2 years after their stroke regarding the occurrence of seizures. The final follow-up for mortality is from April 2015 (follow-up duration 24.5-27.8 years, mean 26.0 years, SD 0.9 years). We compared patients with early-onset seizures with all seizure-free patients, whereas the patients with late-onset seizures were compared with the 1-week survivors without any seizures. We used Cox-regression analyses to correct for possible confounding factors.

RESULTS:

Kaplan-Meier analysis showed significantly higher mortality for the patients with early-onset seizures (p = 0.002) but after correction for known risk factors for (long term) mortality early-onset seizures had no independent influence on long-term mortality (HR 1.09; 95% CI 0.64-1.85). In patients with late-onset seizures, no significant influence from late-onset seizures on long-term mortality was found (univariate p = 0.717; multivariate HR 0.81; 95% CI 0.54-1.20).

CONCLUSION:

Both early-onset and late-onset seizures do not influence long-term mortality after ischemic stroke.

KEYWORDS:

Brain infarct; Epilepsy; Seizures; Stroke

PMID:
29845373
PMCID:
PMC6060746
DOI:
10.1007/s00415-018-8907-7
[Indexed for MEDLINE]
Free PMC Article

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