Acute ischemic stroke treatment and the occurrence of seizures.
OBJECTIVE
Early intravenous treatment with recombinant tissue plasminogen activator (rt-PA) improves the outcome of patients with an acute ischemic stroke. This retrospective observational study analyses whether rt-PA treatment also prevents the occurrence of early- and late-onset seizures.


METHODS
Thirty-eight patients treated with rt-PA were compared to 269 receiving anticoagulants (ACs) and 769 on antithrombotics (ATs) for an acute cardiac- or thrombo-embolic stroke. The epidemiological and clinical data, and the vascular risk factors were determined in the three groups. The incidence, onset and types of seizures were compared.


RESULTS
The patients treated with rt-PA had more severe stroke signs on admission and remained more dependent than those treated with ACs and ATs. The appearance of early-onset seizures was related to the severity of the stroke. The incidence of the late-onset ones tended to be low in the rt-PA group. None of the patients developed status epilepticus or epilepsy.


CONCLUSIONS
The occurrence of early-onset seizures in the rt-PA treated group is related to the severity of the stroke and not to the treatment modality. Thrombolysis prevents partly the occurrence of late-onset seizures, probably, by a better reperfusion of the ischemic brain regions.
De Reuck
Jacques
J
Department of Neurology, University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. dereuck.j@gmail.com
Van Maele
Georges
G
D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010960:Plasminogen Activators / Q000009:adverse effects / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D015424:Reperfusion; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D013923:Thromboembolism / Q000150:complications; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D000927:Anticonvulsants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator