Does treatment with t-PA increase the risk of developing epilepsy after stroke?
Patients suffering from ischemic stroke carry an enhanced risk of developing secondary epilepsy. We sought to clarify whether thrombolytic treatment with recombinant tissue plasminogen activator (t-PA) is independently associated with post-stroke epilepsy (PSE). In this observational study, data fro...
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| Veröffentlicht in: | Journal of neurology 2015-10, Vol.262 (10), p.2364-2372 |
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| creator | Keller, Lena Hobohm, Carsten Zeynalova, Samira Classen, Joseph Baum, Petra |
| description | Patients suffering from ischemic stroke carry an enhanced risk of developing secondary epilepsy. We sought to clarify whether thrombolytic treatment with recombinant tissue plasminogen activator (t-PA) is independently associated with post-stroke epilepsy (PSE). In this observational study, data from 302 stroke patients treated at a single academic neurological department were analyzed retrospectively. Median follow-up was 42 months (maximum 80). Variables included presence of comorbidity, stroke severity, neurological presentation, complications, infarct characteristics, and treatment with t-PA. After univariate analyses, a multivariate analysis was performed to create a model of factors that were significantly associated with PSE, including treatment with t-PA. 13.9 % of patients developed PSE during follow-up. Multivariate analysis identified 5 independent factors for PSE: low Barthel Index at discharge; hemianopia; infection acquired during the hospital stay; involvement of the temporal lobe; involvement of the perirolandic cortex. While the incidence of PSE was higher in patients treated with t-PA (20.6 vs. 10.7 %, univariate analysis;
p
= 0.020), the effect was lost after adjusting for several factors associated with t-PA treatment [odds ratio for PSE after treatment with t-PA 1.3 (95 % CI 0.6–2.9),
p
= 0.489]. This study failed to identify treatment with t-PA as an independent risk factor for PSE. |
| doi_str_mv | 10.1007/s00415-015-7850-0 |
| format | Article |
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p
= 0.020), the effect was lost after adjusting for several factors associated with t-PA treatment [odds ratio for PSE after treatment with t-PA 1.3 (95 % CI 0.6–2.9),
p
= 0.489]. This study failed to identify treatment with t-PA as an independent risk factor for PSE.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-015-7850-0</identifier><identifier>PMID: 26205634</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Bats ; Brain Ischemia - drug therapy ; Convulsions & seizures ; Epilepsy ; Epilepsy - chemically induced ; Female ; Fibrinolytic Agents - adverse effects ; Follow-Up Studies ; Humans ; Ischemia ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Neurology ; Neuroradiology ; Neurosciences ; Observational studies ; Original Communication ; Outcome Assessment (Health Care) - statistics & numerical data ; Stroke ; Stroke - drug therapy ; Tissue Plasminogen Activator - adverse effects</subject><ispartof>Journal of neurology, 2015-10, Vol.262 (10), p.2364-2372</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-664a774192cf18f986477807983c14767842ff4a69a83303f9209eae765e1b553</citedby><cites>FETCH-LOGICAL-c405t-664a774192cf18f986477807983c14767842ff4a69a83303f9209eae765e1b553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-015-7850-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-015-7850-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26205634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keller, Lena</creatorcontrib><creatorcontrib>Hobohm, Carsten</creatorcontrib><creatorcontrib>Zeynalova, Samira</creatorcontrib><creatorcontrib>Classen, Joseph</creatorcontrib><creatorcontrib>Baum, Petra</creatorcontrib><title>Does treatment with t-PA increase the risk of developing epilepsy after stroke?</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Patients suffering from ischemic stroke carry an enhanced risk of developing secondary epilepsy. We sought to clarify whether thrombolytic treatment with recombinant tissue plasminogen activator (t-PA) is independently associated with post-stroke epilepsy (PSE). In this observational study, data from 302 stroke patients treated at a single academic neurological department were analyzed retrospectively. Median follow-up was 42 months (maximum 80). Variables included presence of comorbidity, stroke severity, neurological presentation, complications, infarct characteristics, and treatment with t-PA. After univariate analyses, a multivariate analysis was performed to create a model of factors that were significantly associated with PSE, including treatment with t-PA. 13.9 % of patients developed PSE during follow-up. Multivariate analysis identified 5 independent factors for PSE: low Barthel Index at discharge; hemianopia; infection acquired during the hospital stay; involvement of the temporal lobe; involvement of the perirolandic cortex. While the incidence of PSE was higher in patients treated with t-PA (20.6 vs. 10.7 %, univariate analysis;
p
= 0.020), the effect was lost after adjusting for several factors associated with t-PA treatment [odds ratio for PSE after treatment with t-PA 1.3 (95 % CI 0.6–2.9),
p
= 0.489]. This study failed to identify treatment with t-PA as an independent risk factor for PSE.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bats</subject><subject>Brain Ischemia - drug therapy</subject><subject>Convulsions & seizures</subject><subject>Epilepsy</subject><subject>Epilepsy - chemically induced</subject><subject>Female</subject><subject>Fibrinolytic Agents - adverse effects</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Observational studies</subject><subject>Original Communication</subject><subject>Outcome Assessment (Health Care) - statistics & numerical data</subject><subject>Stroke</subject><subject>Stroke - drug therapy</subject><subject>Tissue Plasminogen Activator - adverse effects</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1LHTEUhkNR6vXjB3RTAm66GT35TlZFtNaCYBd1HXLHEx2dOzNNci3---Z6r6UIgotwIOc5b8h5CPnE4IgBmOMMIJlqoB5jFTTwgcyYFLxhUrktMgMhoVFCyR2ym_M9ANja-Eh2uOagtJAzcnU2YqYlYSgLHAr905U7WpqfJ7Qb2nqbkZY7pKnLD3SM9AYfsR-nbrilOHU9TvmJhlgw0VzS-IBf98l2DH3Gg03dI9fn336dXjSXV99_nJ5cNq0EVRqtZTBGMsfbyGx0VktjLBhnRcuk0cZKHqMM2gUrBIjoODgMaLRCNldK7JEv69wpjb-XmItfdLnFvg8DjsvsmeFGW86Yew_KHbfWrVIPX6H34zIN9SPPVN0aN1AptqbaNOacMPopdYuQnjwDvxLj12J8FeNXYvxq5vMmeTlf4M2_iRcTFeBrINfWcIvpv6ffTP0LVHGU9A</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Keller, Lena</creator><creator>Hobohm, Carsten</creator><creator>Zeynalova, Samira</creator><creator>Classen, Joseph</creator><creator>Baum, Petra</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Does treatment with t-PA increase the risk of developing epilepsy after stroke?</title><author>Keller, Lena ; Hobohm, Carsten ; Zeynalova, Samira ; Classen, Joseph ; Baum, Petra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-664a774192cf18f986477807983c14767842ff4a69a83303f9209eae765e1b553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bats</topic><topic>Brain Ischemia - drug therapy</topic><topic>Convulsions & seizures</topic><topic>Epilepsy</topic><topic>Epilepsy - chemically induced</topic><topic>Female</topic><topic>Fibrinolytic Agents - adverse effects</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Observational studies</topic><topic>Original Communication</topic><topic>Outcome Assessment (Health Care) - statistics & numerical data</topic><topic>Stroke</topic><topic>Stroke - drug therapy</topic><topic>Tissue Plasminogen Activator - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keller, Lena</creatorcontrib><creatorcontrib>Hobohm, Carsten</creatorcontrib><creatorcontrib>Zeynalova, Samira</creatorcontrib><creatorcontrib>Classen, Joseph</creatorcontrib><creatorcontrib>Baum, Petra</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keller, Lena</au><au>Hobohm, Carsten</au><au>Zeynalova, Samira</au><au>Classen, Joseph</au><au>Baum, Petra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does treatment with t-PA increase the risk of developing epilepsy after stroke?</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>262</volume><issue>10</issue><spage>2364</spage><epage>2372</epage><pages>2364-2372</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Patients suffering from ischemic stroke carry an enhanced risk of developing secondary epilepsy. We sought to clarify whether thrombolytic treatment with recombinant tissue plasminogen activator (t-PA) is independently associated with post-stroke epilepsy (PSE). In this observational study, data from 302 stroke patients treated at a single academic neurological department were analyzed retrospectively. Median follow-up was 42 months (maximum 80). Variables included presence of comorbidity, stroke severity, neurological presentation, complications, infarct characteristics, and treatment with t-PA. After univariate analyses, a multivariate analysis was performed to create a model of factors that were significantly associated with PSE, including treatment with t-PA. 13.9 % of patients developed PSE during follow-up. Multivariate analysis identified 5 independent factors for PSE: low Barthel Index at discharge; hemianopia; infection acquired during the hospital stay; involvement of the temporal lobe; involvement of the perirolandic cortex. While the incidence of PSE was higher in patients treated with t-PA (20.6 vs. 10.7 %, univariate analysis;
p
= 0.020), the effect was lost after adjusting for several factors associated with t-PA treatment [odds ratio for PSE after treatment with t-PA 1.3 (95 % CI 0.6–2.9),
p
= 0.489]. This study failed to identify treatment with t-PA as an independent risk factor for PSE.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26205634</pmid><doi>10.1007/s00415-015-7850-0</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Bats Brain Ischemia - drug therapy Convulsions & seizures Epilepsy Epilepsy - chemically induced Female Fibrinolytic Agents - adverse effects Follow-Up Studies Humans Ischemia Male Medicine Medicine & Public Health Middle Aged Multivariate analysis Neurology Neuroradiology Neurosciences Observational studies Original Communication Outcome Assessment (Health Care) - statistics & numerical data Stroke Stroke - drug therapy Tissue Plasminogen Activator - adverse effects |
| title | Does treatment with t-PA increase the risk of developing epilepsy after stroke? |
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