Abstract
Backgrounds: Seizures are one of the most common and hazardous neurological complications of stroke. Post-stroke seizures were classified as early onset seizure and late onset seizure, depending on seizure onset after stroke. Stroke is one of the most common risk factors for seizures and epilepsy, especially in older patients, accounting for 39-45% of all seizure incidents. Knowledge of various risk factors and capability to perform supporting examinations such as EEG are essential to do with the aim of early detection, improving the prevention and treatment of post-stroke seizures so that it is expected to reduce the prevalence and mortality rate of post-stroke seizures. Objectives: This study aims to determine the electroencephalogram (EEG) features found in post-stroke seizure patients in the Department of Neurology, Dr. Soetomo Surabaya Hospital Methods: This study is a descriptive observational study using secondary data obtained from the medical records of patients with post-stroke seizures at the Department of Neurology, Dr. Soetomo Surabaya Hospital within the time period of January 2017 ? December 2019. Results: In this research, we evaluated seizure characteristics in 230 patients who had ischemic and hemorrhagic stroke. 116 patients were male (50.4%) while 114 patients were female (49.6%). The highest age range found in the study sample was > 19-60 years. In addition, this study revealed that 58.7% of seizures were focal seizures and 39.1% were generalized seizures, the remaining 2.2% were unknown seizures. Focal seizures become bilateral tonic clonic seizures are the most common type of focal seizures while generalized tonic clonic seizures are the most common type of generalized seizures seen. 80% of patients with focal seizures have impaired awareness during seizures. Seizures occurred in 148 ischemic stroke patients (64.3%) and 82 hemorrhagic stroke patients (35.7%). 97 Patients with ischemic stroke had thrombus etiology (65. 5%) and 32 had an embolic etiology (21.6 %), while patients with hemorrhagic stroke had the most dominant etiology, namely ICH as many as 53 patients (64.6%). lesions were cortical (47.8%) and 91 patients had lesions located subcortical (39.6%). The majority of patients experienced early onset seizures (55.2%) and the majority of patients had EEG recordings 7 - < 14 days and 3 - < 7 days after seizure manifestations (29.1%). EEG results showed abnormal features in 78.7% patients. Slow activity EEG is the most visible EEG picture with Continuous Slow Activity (CSA) as the most dominant pattern, while in epileptiform EEG the sharp/spike wave image is the most common pattern. In the EEG special pattern, the most common picture is asymmetry decreased background rhythm accompanied by CSA. Conclusion: This hospital-based study showed that post-stroke seizures were associated with young and middle aged (>19-60 years), male gender, ischemic stroke, thrombus type, cortical location, and comorbid hypertension, with a high prevalence rate in patients with hypertension. Based on this study, our data showed that patients with post-stroke seizures after stroke were more likely to have impaired awareness during the seizure. The most EEG features found in this study are continuous slow activity waves. In this study, post stroke seizures occurred more commonly after ischemic stroke, middle aged, and when stroke occurred in the cortical region
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