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J Neurol Neurosurg Psychiatry. 2005 Dec;76(12):1649-53. doi: 10.1136/jnnp.2005.064535.

Influence of pre-existing dementia on the risk of post-stroke epileptic seizures.

Journal of neurology, neurosurgery, and psychiatry

C Cordonnier, H Hénon, P Derambure, F Pasquier, D Leys

Affiliations

  1. Department of Neurology, Stroke Unit, Hôpital Roger Salengro, F-59037 Lille, France.

PMID: 16291888 PMCID: PMC1739446 DOI: 10.1136/jnnp.2005.064535

Abstract

BACKGROUND: Seizures occur in 10% of stroke patients, but their predictors have not been clearly identified. Pre-existing dementia is present in 12-16% of stroke patients and, at the community level, patients with dementia have increased risk of seizures. However, the question of whether pre-existing dementia is associated with a higher risk of seizures after stroke has never been studied.

AIM: To evaluate whether pre-existing dementia is associated with an increased risk of seizures after stroke.

METHODS: The study was conducted on 202 consecutive stroke patients recruited to the Lille stroke/dementia study (97 men; median age, 75 years; range, 42-100). Pre-stroke cognitive functions were evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly, with a cutoff value of 104 for the diagnosis of dementia. Seizures were defined as early seizures when occurring within seven days of stroke onset, and as late seizures when occurring more than seven days after stroke.

RESULTS: Of 202 patients, 33 (16.3%) met the criteria for pre-existing dementia, and 11 (5.4%) developed early seizures. During 289 person-years of follow up, 14 patients developed late seizures, resulting in an incidence rate of 4.8 new cases/100 person-years. Pre-existing dementia was not associated with the occurrence of early seizures, but was independently associated with the occurrence of late seizures (adjusted odds ratio, 4.66; 95% confidence interval, 1.34 to 16.21).

CONCLUSION: Stroke patients with pre-existing dementia have an increased risk of late seizures. Any factor increasing the risk of seizures (drugs, metabolic changes) should be avoided in these patients.

References

  1. Stroke. 1997 Aug;28(8):1585-9 - PubMed
  2. Arch Neurol. 1996 Jun;53(6):532-6 - PubMed
  3. BMJ. 1997 Dec 13;315(7122):1582-7 - PubMed
  4. Eur Neurol. 2000;43(1):3-8 - PubMed
  5. Arch Neurol. 2000 Nov;57(11):1617-22 - PubMed
  6. Cerebrovasc Dis. 2001;11(3):216-24 - PubMed
  7. Neurology. 2001 Oct 9;57(7):1216-22 - PubMed
  8. Dement Geriatr Cogn Disord. 2002;14(3):137-40 - PubMed
  9. Neurology. 2003 Feb 11;60(3):400-4 - PubMed
  10. Stroke. 2004 Jul;35(7):1769-75 - PubMed
  11. J Psychiatr Res. 1975 Nov;12(3):189-98 - PubMed
  12. Br J Psychiatry. 1988 Feb;152:209-13 - PubMed
  13. Neurobiol Aging. 1989 Sep-Oct;10(5):593-602 - PubMed
  14. Psychol Med. 1989 Nov;19(4):1015-22 - PubMed
  15. Arch Neurol. 1990 Feb;47(2):157-60 - PubMed
  16. Med J Aust. 1990 Aug 20;153(4):192-6 - PubMed
  17. Psychol Med. 1991 Aug;21(3):785-90 - PubMed
  18. Stroke. 1993 Jan;24(1):35-41 - PubMed
  19. Epilepsia. 1993 Jan-Feb;34(1):141-3 - PubMed
  20. Epilepsia. 1993 May-Jun;34(3):453-68 - PubMed
  21. Epilepsia. 1994 Sep-Oct;35(5):959-64 - PubMed
  22. Acta Neurol Scand. 1994 Aug;90(2):83-5 - PubMed
  23. Alzheimer Dis Assoc Disord. 1995 Summer;9(2):105-11 - PubMed
  24. Dementia. 1995 Sep-Oct;6(5):258-63 - PubMed
  25. Br J Psychiatry. 1995 Oct;167(4):541-4 - PubMed
  26. Neurology. 1996 Mar;46(3):727-30 - PubMed
  27. Neurology. 1996 Feb;46(2):350-5 - PubMed
  28. Stroke. 1997 Dec;28(12):2429-36 - PubMed

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