Sethuram, A (2006) Prevalence and Pattern of Seizures in Arterial Stroke Patients. Masters thesis, Madurai Medical College, Madurai.
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Abstract
Strokes are one of the major cause of admission in any general hospital. In the last two decades the mortality of strokes has considerably reduced because of the recognition and treatment of the various risk factors. However, even today, a large ischemic infarct carries a mortality of about 15 percent and this increases to 30-50 percent for large intra-cerebral hemorrhages, the final common terminal events being due to rise of intra-cranial pressure. The other common causes of death following strokes are aspiration pneumonia, pulmonary embolism, cardiac arrhythmias, seizures and myocardial infarction. Seizures and its complications may directly and indirectly influenze the outcome following a stroke. Recent advances in basic and clinical research have shown potential for improvement in stroke patients, the main thrust in the field of reperfusion and neuronal protection. All these newer therapies have to be administered within a time frame which constitutes the “Therapeutic Window”. Intensive stroke care units had made an impact in reducing the mortality and morbidity1. Seizures and Stroke are two important clinical problems in Neurology practice. Some of the patients develop seizures during acute phase of stroke, while others develop late onset poststroke seizures. Seizures in either phase further compromises neuronal function and recovery. So seizures during and after stroke must be managed effectively. Seizures can be a life-threatening complication of acute stroke. Status epilepticus (SE) was observed in 20% of stroke patients2. Other pattern of seizures like GTCS, (generalized tonic clonic seizures), partial seizures, complex partial seizures and non convulsive status epilepticus were observed in stroke patients. Though studies considering various aspects of stroke were carried out in India, less report were available on seizures among stroke population. The present study was undertaken to know more about prevalence and pattern of seizures in arterial stroke patient and their clinical aspects, as well as to compare with the published reports. More over no such work was carried out earlier on this aspect in this hospital and this area. Conclusion 1. The prevalence of seizures in arterial stroke was 15% 2. Pattern of seizures observed were partial seizure in 8 and generalized seizure in 2 cases. 3. Complex partial seizure (CPS) and status epilepticus (SE) were not observed during the study period. 4. The median time for the occurrence of seizures in arterial stroke was 12 hours. However, it ranged from 0-72 hours in hospital follow up. 5. Recurrent seizures were seen in two only. 6. Occurrence of seizures in arterial stroke was independent of age and gender. 7. Seizures were noticed more among those with hemorrhagic lesion (cortical) and in those who had anterior circulation stroke. 8. Seizures were well controlled with oral phenytoin in all except two during the follow up period. The reason for failures were poor drug compliance in one and extensive stroke in other case. 9. Epileptiform activity in EEG were noticed in 19 cases of arterial stroke out of which only 10 developed clinical seizures. 10. During the three month follow up six of the 66 (9%) expired and three were lost for follow up. Seizures were observed in arterial stroke. It has an impact on the natural course and outcome of stroke cases. In view of scanty literature in this area of stroke, an attempt has been made to find out the prevalence and pattern of seizures among arterial stroke cases with special reference to time of occurrence, underlying pathological status and response to anti-epileptic drugs. A cross sectional study was designed after institutional ethical approval to study 540 cases of stroke admitted to a tertiary care teaching hospital over a period of 12 consecutive months. A rigid inclusion and exclusion criteria were adopted to select cases of first onset acute arterial stroke. They were evaluated clinically and by investigation methods to find out the occurrence of seizures among them. Their data were analysed by simple descriptive statistics.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Prevalence and Pattern ; Seizures ; Arterial Stroke ; Patients. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 03 Jul 2017 08:19 |
| Last Modified: | 03 Jul 2017 08:19 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/774 |
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