Publicação
Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients
| Resumo: | Objective: Seizures and electroencephalographic (EEG) abnormalities have been associated with unfavorable stroke functional outcome. However, this association may depend on clinical and imaging stroke severity. We set out to analyze whether epileptic seizures and early EEG abnormalities are predictors of stroke outcome after adjustment for age and clinical/imaging infarct severity. Methods: A prospective study was made on consecutive and previously independent acute stroke patients with a National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 on admission and an acute anterior circulation ischemic lesion on brain imaging. All patients underwent standardized clinical and diagnostic assessment during admission and after discharge, and were followed for 12 months. Video-EEG (<60 min) was performed in the first 72 h. The Alberta Stroke Program Early CT Score quantified middle cerebral artery infarct size. The outcomes in this study were an unfavorable functional outcome (modified Rankin Scale [mRS] ≥ 3) and death (mRS = 6) at discharge and 12 months after stroke. Results: Unfavorable outcome at discharge was independently associated with NIHSS score (p = 0.001), EEG background activity slowing (p < 0.001), and asymmetry (p < 0.001). Unfavorable outcome 1 year after stroke was independently associated with age (p = 0.001), NIHSS score (p < 0.001), remote symptomatic seizures (p = 0.046), EEG background activity slowing (p < 0.001), and asymmetry (p < 0.001). Death in the first year after stroke was independently associated with age (p = 0.028), NIHSS score (p = 0.001), acute symptomatic seizures (p = 0.015), and EEG suppression (p = 0.019). Significance: Acute symptomatic seizures were independent predictors of vital outcome and remote symptomatic seizures of functional outcome in the first year after stroke. Therefore, their recognition and prevention strategies may be clinically relevant. Early EEG abnormalities were independent predictors and comparable to age and early clinical/imaging infarct severity in stroke functional outcome discrimination, reflecting the concept that EEG is a sensitive and robust method in the functional assessment of the brain. |
|---|---|
| Autores principais: | Bentes, Carla |
| Outros Autores: | Peralta, Ana Rita; Martins, Hugo F G; Casimiro, Carlos; Morgado, Carlos; Franco, Ana Catarina; Viana, Pedro; Fonseca, Ana Catarina; Geraldes, Ruth; Canhão, Patrícia; Melo, Teresa Pinho e; Paiva, Teresa; Ferro, José |
| Assunto: | Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866809931264425984 |
|---|---|
| author | Bentes, Carla |
| author2 | Peralta, Ana Rita Martins, Hugo F G Casimiro, Carlos Morgado, Carlos Franco, Ana Catarina Viana, Pedro Fonseca, Ana Catarina Geraldes, Ruth Canhão, Patrícia Melo, Teresa Pinho e Paiva, Teresa Ferro, José |
| author2_role | author author author author author author author author author author author author |
| author_facet | Bentes, Carla Peralta, Ana Rita Martins, Hugo F G Casimiro, Carlos Morgado, Carlos Franco, Ana Catarina Viana, Pedro Fonseca, Ana Catarina Geraldes, Ruth Canhão, Patrícia Melo, Teresa Pinho e Paiva, Teresa Ferro, José |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Bentes, Carla\",\"Person.identifier.orcid\":\"0000-0003-2399-7678\"},{\"Person.name\":\"Peralta, Ana Rita\"},{\"Person.name\":\"Martins, Hugo F G\",\"Person.identifier.orcid\":\"0000-0001-6686-1944\"},{\"Person.name\":\"Casimiro, Carlos\"},{\"Person.name\":\"Morgado, Carlos\"},{\"Person.name\":\"Franco, Ana Catarina\",\"Person.identifier.orcid\":\"0000-0002-4371-9272\"},{\"Person.name\":\"Viana, Pedro\",\"Person.identifier.orcid\":\"0000-0003-0861-8705\"},{\"Person.name\":\"Fonseca, Ana Catarina\",\"Person.identifier.orcid\":\"0000-0001-6913-5526\"},{\"Person.name\":\"Geraldes, Ruth\"},{\"Person.name\":\"Canhão, Patrícia\",\"Person.identifier.orcid\":\"0000-0003-3816-0416\"},{\"Person.name\":\"Melo, Teresa Pinho e\",\"Person.identifier.orcid\":\"0000-0002-0375-0101\"},{\"Person.name\":\"Paiva, Teresa\",\"Person.identifier.orcid\":\"0000-0002-7937-7841\"},{\"Person.name\":\"Ferro, José\",\"Person.identifier.orcid\":\"0000-0002-2343-9097\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Bentes, Carla Peralta, Ana Rita Martins, Hugo F G Casimiro, Carlos Morgado, Carlos Franco, Ana Catarina Viana, Pedro Fonseca, Ana Catarina Geraldes, Ruth Canhão, Patrícia Melo, Teresa Pinho e Paiva, Teresa Ferro, José |
| datacite.date.Accepted.fl_str_mv | 2017-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2020-11-16T16:31:38Z |
| datacite.date.embargoed.fl_str_mv | 2020-11-16T16:31:38Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| datacite.titles.title.fl_str_mv | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Bentes, Carla Peralta, Ana Rita Martins, Hugo F G Casimiro, Carlos Morgado, Carlos Franco, Ana Catarina Viana, Pedro Fonseca, Ana Catarina Geraldes, Ruth Canhão, Patrícia Melo, Teresa Pinho e Paiva, Teresa Ferro, José |
| dc.date.Accepted.fl_str_mv | 2017-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2020-11-16T16:31:38Z |
| dc.date.embargoed.fl_str_mv | 2020-11-16T16:31:38Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10451/44890 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | John Wiley & Sons, Inc. |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| dc.title.fl_str_mv | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Objective: Seizures and electroencephalographic (EEG) abnormalities have been associated with unfavorable stroke functional outcome. However, this association may depend on clinical and imaging stroke severity. We set out to analyze whether epileptic seizures and early EEG abnormalities are predictors of stroke outcome after adjustment for age and clinical/imaging infarct severity. Methods: A prospective study was made on consecutive and previously independent acute stroke patients with a National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 on admission and an acute anterior circulation ischemic lesion on brain imaging. All patients underwent standardized clinical and diagnostic assessment during admission and after discharge, and were followed for 12 months. Video-EEG (<60 min) was performed in the first 72 h. The Alberta Stroke Program Early CT Score quantified middle cerebral artery infarct size. The outcomes in this study were an unfavorable functional outcome (modified Rankin Scale [mRS] ≥ 3) and death (mRS = 6) at discharge and 12 months after stroke. Results: Unfavorable outcome at discharge was independently associated with NIHSS score (p = 0.001), EEG background activity slowing (p < 0.001), and asymmetry (p < 0.001). Unfavorable outcome 1 year after stroke was independently associated with age (p = 0.001), NIHSS score (p < 0.001), remote symptomatic seizures (p = 0.046), EEG background activity slowing (p < 0.001), and asymmetry (p < 0.001). Death in the first year after stroke was independently associated with age (p = 0.028), NIHSS score (p = 0.001), acute symptomatic seizures (p = 0.015), and EEG suppression (p = 0.019). Significance: Acute symptomatic seizures were independent predictors of vital outcome and remote symptomatic seizures of functional outcome in the first year after stroke. Therefore, their recognition and prevention strategies may be clinically relevant. Early EEG abnormalities were independent predictors and comparable to age and early clinical/imaging infarct severity in stroke functional outcome discrimination, reflecting the concept that EEG is a sensitive and robust method in the functional assessment of the brain. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/c0b5adc4-b6cd-44dd-b9dc-99725fe29a88/download |
| id | ul_41c6475aa93d9c8ea7ddc76d8cbd50df |
| identifier.url.fl_str_mv | http://hdl.handle.net/10451/44890 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10451/44890 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Bentes, Carla Bentes, Carla https://www.ciencia-id.pt/7D1C-D5DD-C579 7D1C-D5DD-C579 http://orcid.org/0000-0003-2399-7678 0000-0003-2399-7678 Peralta, Ana Rita Martins, Hugo F G Martins, Hugo F G http://orcid.org/0000-0001-6686-1944 0000-0001-6686-1944 Casimiro, Carlos Morgado, Carlos Franco, Ana Catarina Franco, Ana Catarina https://www.ciencia-id.pt/9313-9F25-E425 9313-9F25-E425 http://orcid.org/0000-0002-4371-9272 0000-0002-4371-9272 Viana, Pedro Viana, Pedro http://orcid.org/0000-0003-0861-8705 0000-0003-0861-8705 Fonseca, Ana Catarina Fonseca, Ana Catarina http://orcid.org/0000-0001-6913-5526 0000-0001-6913-5526 Geraldes, Ruth Canhão, Patrícia Canhão, Patrícia https://www.ciencia-id.pt/8F12-6A40-BE2E 8F12-6A40-BE2E http://orcid.org/0000-0003-3816-0416 0000-0003-3816-0416 Melo, Teresa Pinho e Melo, Teresa Pinho e http://orcid.org/0000-0002-0375-0101 0000-0002-0375-0101 Paiva, Teresa Paiva, Teresa https://www.ciencia-id.pt/7B10-224A-DB1D 7B10-224A-DB1D http://orcid.org/0000-0002-7937-7841 0000-0002-7937-7841 Ferro, José Ferro, José https://www.ciencia-id.pt/6F16-7E25-7AAF 6F16-7E25-7AAF http://orcid.org/0000-0002-2343-9097 0000-0002-2343-9097 |
| publishDate | 2017 |
| publisher.none.fl_str_mv | John Wiley & Sons, Inc. |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engJohn Wiley & Sons, Inc.pt_PTObjective: Seizures and electroencephalographic (EEG) abnormalities have been associated with unfavorable stroke functional outcome. However, this association may depend on clinical and imaging stroke severity. We set out to analyze whether epileptic seizures and early EEG abnormalities are predictors of stroke outcome after adjustment for age and clinical/imaging infarct severity. Methods: A prospective study was made on consecutive and previously independent acute stroke patients with a National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 on admission and an acute anterior circulation ischemic lesion on brain imaging. All patients underwent standardized clinical and diagnostic assessment during admission and after discharge, and were followed for 12 months. Video-EEG (<60 min) was performed in the first 72 h. The Alberta Stroke Program Early CT Score quantified middle cerebral artery infarct size. The outcomes in this study were an unfavorable functional outcome (modified Rankin Scale [mRS] ≥ 3) and death (mRS = 6) at discharge and 12 months after stroke. Results: Unfavorable outcome at discharge was independently associated with NIHSS score (p = 0.001), EEG background activity slowing (p < 0.001), and asymmetry (p < 0.001). Unfavorable outcome 1 year after stroke was independently associated with age (p = 0.001), NIHSS score (p < 0.001), remote symptomatic seizures (p = 0.046), EEG background activity slowing (p < 0.001), and asymmetry (p < 0.001). Death in the first year after stroke was independently associated with age (p = 0.028), NIHSS score (p = 0.001), acute symptomatic seizures (p = 0.015), and EEG suppression (p = 0.019). Significance: Acute symptomatic seizures were independent predictors of vital outcome and remote symptomatic seizures of functional outcome in the first year after stroke. Therefore, their recognition and prevention strategies may be clinically relevant. Early EEG abnormalities were independent predictors and comparable to age and early clinical/imaging infarct severity in stroke functional outcome discrimination, reflecting the concept that EEG is a sensitive and robust method in the functional assessment of the brain.application/pdfpt_PTSeizures, electroencephalographic abnormalities, and outcome of ischemic stroke patientsPersonalBentes, CarlaDSpacehttp://dspace.org/items/0bc2f877-0ad3-408c-82ee-b5378a014734DSpacehttp://dspace.org/items/0bc2f877-0ad3-408c-82ee-b5378a014734BentesCarlaCiência IDhttps://www.ciencia-id.pt7D1C-D5DD-C579ORCIDhttp://orcid.org0000-0003-2399-7678Scopus Author IDhttps://www.scopus.com6603395191Peralta, Ana RitaPersonalMartins, Hugo F GDSpacehttp://dspace.org/items/e2d79411-f5e2-4542-9c03-f93cb28e111cDSpacehttp://dspace.org/items/e2d79411-f5e2-4542-9c03-f93cb28e111cMartinsHugoORCIDhttp://orcid.org0000-0001-6686-1944Casimiro, CarlosMorgado, CarlosPersonalFranco, Ana CatarinaDSpacehttp://dspace.org/items/5f3419a3-c23d-4e82-838d-9bebe37b3a26DSpacehttp://dspace.org/items/5f3419a3-c23d-4e82-838d-9bebe37b3a26FrancoAna CatarinaCiência IDhttps://www.ciencia-id.pt9313-9F25-E425ORCIDhttp://orcid.org0000-0002-4371-9272PersonalViana, PedroDSpacehttp://dspace.org/items/e22897a7-0bb2-4e48-8b22-d70ddea4c03fDSpacehttp://dspace.org/items/e22897a7-0bb2-4e48-8b22-d70ddea4c03fVianaPedroORCIDhttp://orcid.org0000-0003-0861-8705PersonalFonseca, Ana CatarinaDSpacehttp://dspace.org/items/9b6049cb-46fb-4d04-9d21-94878cc3c818DSpacehttp://dspace.org/items/9b6049cb-46fb-4d04-9d21-94878cc3c818FonsecaAna CatarinaORCIDhttp://orcid.org0000-0001-6913-5526Scopus Author IDhttps://www.scopus.com16452610900Geraldes, RuthPersonalCanhão, PatríciaDSpacehttp://dspace.org/items/e9d5a53f-d0d3-4cc4-9807-879ef76be505DSpacehttp://dspace.org/items/e9d5a53f-d0d3-4cc4-9807-879ef76be505CanhãoPatríciaCiência IDhttps://www.ciencia-id.pt8F12-6A40-BE2EORCIDhttp://orcid.org0000-0003-3816-0416Scopus Author IDhttps://www.scopus.com6603685711PersonalMelo, Teresa Pinho eDSpacehttp://dspace.org/items/e74412bf-766d-4f86-b55f-76f6a1cb3eb4DSpacehttp://dspace.org/items/e74412bf-766d-4f86-b55f-76f6a1cb3eb4Pinho e MeloTeresaORCIDhttp://orcid.org0000-0002-0375-0101PersonalPaiva, TeresaDSpacehttp://dspace.org/items/c720c5dd-a926-4737-938d-a90e782dd837DSpacehttp://dspace.org/items/c720c5dd-a926-4737-938d-a90e782dd837PaivaMaria Teresa Aguiar dos SantosCiência IDhttps://www.ciencia-id.pt7B10-224A-DB1DORCIDhttp://orcid.org0000-0002-7937-7841Scopus Author IDhttps://www.scopus.com7005950248PersonalFerro, JoséDSpacehttp://dspace.org/items/9a568ce6-d218-44fc-982c-0ffe7bffc197DSpacehttp://dspace.org/items/9a568ce6-d218-44fc-982c-0ffe7bffc197Morão Cabral FerroJosé ManuelCiência IDhttps://www.ciencia-id.pt6F16-7E25-7AAFORCIDhttp://orcid.org0000-0002-2343-9097HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptDOIIsPartOf10.1002/epi4.120752020-11-16T16:31:38Z20172017-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/44890http://purl.org/coar/access_right/c_abf2open accessAlberta Stroke Program Early CT ScoreEEGEpilepsyOutcomeSeizuresStroke195171 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal article2017http://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/c0b5adc4-b6cd-44dd-b9dc-99725fe29a88/downloadEpilepsia Open24441452 |
| spellingShingle | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients Bentes, Carla Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| status | SINGLETON |
| subject.fl_str_mv | Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| title | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| title_full | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| title_fullStr | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| title_full_unstemmed | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| title_short | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| title_sort | Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients |
| topic | Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| topic_facet | Alberta Stroke Program Early CT Score EEG Epilepsy Outcome Seizures Stroke |
| url | http://hdl.handle.net/10451/44890 |
| visible | 1 |