Signficant Risk of Seizures After Stroke Treatment With Reperfusion Therapies

IV injection
IV injection
Patients undergoing treatment for ischemic stroke are at greater risk for seizure development.
The following article is part of live conference coverage from the 2017 American Epilepsy Society Annual Meeting in Washington, DC. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AES 2017.

WASHINGTON, DC – Patients with acute stroke who receive reperfusion therapy with intravenous tissue plasminogen activator (IV-tPA) and/or intra-arterial therapy (IAT) are at greater risk of developing seizures than patients who do not receive acute therapies, according to findings presented at the 2017 American Epilepsy Society Annual Meeting, December 1-5, 2017 in Washington, DC.

The multicenter cohort study included 1943 patients with ischemic stroke, of whom 1375 received no acute therapies, 363 received IV-tPA alone, 205 received IAT and IV-tPA, and 93 received IAT alone. Patients were included if they experienced seizures up to 2 years from stroke onset.

Incidence of seizures was 2% after no therapy, 5.8% after IV-tPA alone, 8.3% after IAT and IV-tPA, and 12.9% after IAT alone. Compared with controls, there was a significant association between patients who received IV-tPA alone (odds ratio [OR] 2.5; 95% CI, 1.3-5.0; P =.009), IV-tPA and IAT (OR 3.2; 95% CI, 1.4-7.4; P =.006), and IAT alone (OR 3.8; 95% CI, 1.5-9.6; P =.005) and seizure development. The researchers noted that hemorrhagic transformation was also a risk factor for seizure development in the IAT plus IV-tPA and IAT alone groups (P =.008 and P =.011, respectively).

Based on the findings, the researchers suggest that patients with acute stroke who receive IV-tPA and IAT may benefit from longer follow-up periods after stroke onset in order to better monitor seizure risk and outcomes.

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Disclosures: The researchers report financial support from the International Research and Research Training Fund.

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Naylor J, Thevathasan A, Churilov L, et al. Association between different acute stroke therapies and development of post stroke seizures. Presented at: 2017 American Epilepsy Society Annual Meeting. December 1-5, 2017; Washington, DC. Abstract 1.261.