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| EEF findings predict post-stroke seizure |
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16 June 2006
Researchers from Belgium have identified post-stroke electroencephalogram (EEG) patterns that may help to identify patients at risk of seizures. "It is important to determine which stroke patients will develop late-onset seizures, because of their possible harmful nature," they write in the journal European Neurology.
To address this issue, the team from University Hospital in Ghent, led by Dr Jacques De Reuck, studied EEG findings from 12 stroke patients with early-onset seizures, 98 with late-onset seizures, and 275 control patients who did not develop seizures.
EEG results obtained after stroke, but prior to seizure onset, were available for 69 patients. Post-stroke EEG findings were normal for 53.8% of control individuals compared with just 8.7% of patients who subsequently suffered seizures. Around 40% of all patients had focal slowing on EEG, but 21.7% of seizure patients had diffuse slowing compared with just 5% of controls. Periodic lateralised epileptic discharges (PLEDs) occurred in 5.8% of patients who developed seizures but in none of the controls, while frontal intermittent rhythmic delta activities (FIRDAs) were present in 24% of seizure patients compared with 1.1% of controls.
The investigators note that the possibility of late-onset seizures cannot be completely ruled out for the three control patients with FIRDAs as these patients were followed-up for less than a year, and two died within this period. A quarter of patients who developed early-onset seizures had either PLEDs or FIRDAs on their post-stroke EEGs, while a third had diffuse slowing. In contrast, focal slowing and FIRDAs were more frequently associated with late-onset seizures, at respective rates of 26.5% and 14.3%.
"This study shows that EEG recording after stroke is useful and is of additional value for the detection of late-onset seizures," Dr De Reuck et al conclude. "Taking into account that the incidence of late-onset seizures in relation to cerebrovascular disease is only 8.9%, one can now better define the 'high-risk' patient." "As, on the one hand, seizures are probably harmful and increase the disability of stroke patients, and on the other hand, anti-epileptic drugs can impair cognition, these criteria can allow to select those patients to be treated with anti-epileptic drugs."
Reference:
Eur Neurol 2006; 55 (4): 209-213.
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