Seizures and Epilepsy After Stroke : Epidemiology, Biomarkers and Management
Galovic, Marian (Chalfont Centre for Epilepsy)
Ferreira-Atuesta, Carolina (Icahn School of Medicine at Mount Sinai. Department of Neurology)
Abraira del Fresno, Laura (Hospital Universitari Vall d'Hebron)
Döhler, Nico (Specialist Clinic for Neurorehabilitation, Kliniken Beelitz)
Sinka, Lucia (University Hospital Zurich (Suïssa))
Brigo, Francesco (Division of Neurology, "Franz Tappeiner" Hospital)
Bentes, Carla (Hospital de Santa Maria-CHLN. Department of Neurosciences and Mental Health (Neurology))
Zelano, Johan (Sahlgrenska University Hospital (Suècia))
Koepp, Matthias J. (Chalfont Centre for Epilepsy)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	Stroke is the leading cause of seizures and epilepsy in older adults. Patients who have larger and more severe strokes involving the cortex, are younger, and have acute symptomatic seizures and intracerebral haemorrhage are at highest risk of developing post-stroke epilepsy. Prognostic models, including the SeLECT and CAVE scores, help gauge the risk of epileptogenesis. Early electroencephalogram and blood-based biomarkers can provide information additional to the clinical risk factors of post-stroke epilepsy. The management of acute versus remote symptomatic seizures after stroke is markedly different. The choice of an ideal antiseizure medication should not only rely on efficacy but also consider adverse effects, altered pharmacodynamics in older adults, and the influence on the underlying vascular co-morbidity. Drug-drug interactions, particularly those between antiseizure medications and anticoagulants or antiplatelets, also influence treatment decisions. In this review, we describe the epidemiology, risk factors, biomarkers, and management of seizures after an ischaemic or haemorrhagic stroke. We discuss the special considerations required for the treatment of post-stroke epilepsy due to the age, co-morbidities, co-medication, and vulnerability of stroke survivors.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; Article ; Versió publicada
Publicat a:	Drugs & Aging, Vol. 38 (february 2021) , p. 285-299, ISSN 1179-1969

DOI: 10.1007/s40266-021-00837-7
PMID: 33619704

15 p, 2.1 MB

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