Poststroke seizure risk is similar across reperfusion therapies

  • Lekoubou A & al.
  • Stroke
  • 10/08/2020

  • Susan London
  • Clinical Essentials
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Takeaway

  • About 6% of patients with ischemic stroke who receive reperfusion therapy develop seizures, regardless of the type of therapy.

Why this matters

Key results

  • Pooled incidence of poststroke seizures was 5.9%.
  • Incidences by acute reperfusion therapy type:
    • 6.1% with intravenous thrombolysis (IVT).
    • 5.9% with mechanical thrombectomy.
    • 5.8% with both.
  • Incidences by time:
    • 3.14% for early poststroke seizures (≤7 days after stroke).
    • 6.7% for late poststroke seizures (>7 days after stroke).
  • Compared with non-IVT, IVT was not associated with poststroke seizures (pooled OR, 1.24; 95% CI, 0.75-2.05).
  • Too few studies were identified to assess ORs for mechanical thrombectomy alone or in combination with IVT.

Study design

  • Systematic review and meta-analysis of 25 studies among 13,753 patients with acute ischemic stroke.
  • Main outcome: overall and treatment-specific pooled incidence of poststroke seizures after acute reperfusion therapy.
  • Funding: None.

Limitations

  • Most studies took place in Western countries and China.
  • Inability to tease out additive vs multiplicative effects of IVT and mechanical thrombectomy when combined.