A study of Seizures in Stroke.

Rachel, Packiaseeli (2013) A study of Seizures in Stroke. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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Seizures are a common phenomenon after stroke. Despite being first recognized more than a century ago, many questions regarding seizures in stroke remain unanswered. Stroke related seizures are a neglected topic and generally considered as a benign complication occurring in the course of a progressive and longstanding cerebro vascular disease. Differences in the study design, definition of late or early seizures, target population, inclusion and exclusion criteria, and data on imaging limit a direct comparison of the seizures and may explain the contradictory results in the literature. The incidence of post stroke seizure in India is 13%.9 There have been very few prospective studies in stroke related seizures from the Indian subcontinent. This study was designed to determine the time of onset, semiology, recurrence, impact of comorbid conditions, mortality and the anatomical location of stroke in relation to seizure. AIM OF THE STUDY: 1. To study the semiology of seizures in stroke. 2. To analyze the occurrence of seizures in relation to stroke subtype 3. To study the time of onset of seizures in stroke. 4. To study the anatomical location of the lesion in stroke and the occurrence of seizure. 5. To analyze the recurrent seizures occurring in stroke. METHODS: After obtaining consent either from patients or relatives, all the patients in the study group were evaluated by complete medical history, neurological examination and routine baseline investigations. Axial CT brain was done in all patients, MRI was done in affordable patients. CONCLUSION: 1. Partial seizures are common in stroke related seizures than GTCS, CPS being the rarest presentation. 2. Early onset seizure (seizures within 2 weeks of stroke) is the most common type of stroke related seizure. 3. Seizures are common in a). cortical lesions than with isolated subcortical lesions. b). Left sided lesions than with right sided lesions. 4. In patients with ischaemic stoke, seizures are more common with large infarcts (infarct size >5cm) and in parietal subgroup which includes a major portion of the temporal lobe. 5. In haemorrhagic stroke, lobar ICH and large volume ICH (>30 ml) have the risk for developing post stroke seizures. 6. The factors contributing to recurrence in post stroke seizures include late onset seizures, post ischaemic seizures, presence of PLEDS in EEG and poor AED compliance. 7. Associated comorbid conditions also play a role in stroke related seizures. 8. Mortality related to post stroke seizures is higher in early onset seizure than in late onset seizure. Despite the relatively lower incidence of seizures after stroke, post stroke seizure is one of the most common causes of epilepsy due to high incidence of stroke. Much additional work is needed to better understand the social impact of post stroke seizures, their prevention and effective management. Areas of future research regarding seizures in stroke include assessing the delayed patient outcomes and developing newer antiepileptic drugs with more neuroprotective effects. Post stroke seizure may also become a basic model in research that aims to prevent the injured cerebral cells into an epileptic focus.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Seizures ; Stroke.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 03 Jul 2017 08:37
Last Modified: 03 Jul 2017 08:37
URI: http://repository-tnmgrmu.ac.in/id/eprint/811

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