Clinical characteristics and risk factors in elderly patients with post-stroke seizures / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the risk factors and seizure types of secondary seizures in elderly patients with acute ischemic stroke(AIS),and to screen the effective indicators for predicting Post-stroke seizures(PSS). Methods Elderly patients who were hospitalized in Henan Provincial People's Hospital from January 2019 to June 2020 and diagnosed with AIS for the first time were consecutively collected. The patients were followed up for 1 year and divided into the observation group and the control group according to whether they developed secondary PSS,and the patients in the observation group were divided into subgroups according to the time of secondary PSS. The demographic and clinical characteristics of the patients were recorded,and the National Institutes of Health Stroke Scale(NIHSS) score and Modified Rankin Scale(mRS) score were used to assess stroke severity and outcome at discharge,respectively. Univariate and multivariate Logistic regression analyses were used to identify the independent risk factors for PSS. Results (1)Comparison of general information:There were statistically significant differences in gender,lesion location,hemorrhagic transformation(HT),NIHSS score ≥11,hypertension,cardiac cerebral embolism(CE) and baseline NIHSS score between the observation group and the control group(P<0.05). (2)Results of Multivariate Logistic regression analysis:Cortical infarction(OR=1.702,95%CI 1.172-2.471,P=0.005),HT(OR=2.384,95%CI 1.605-3.434,P<0.001) and NIHSS scores ≥11(OR=1.723,95%CI 1.188-2.500,P=0.004) were independent risk factors for PSS,and the differences were statistically significant. (3)Comparison of early-onset seizures(ES) and late-onset seizures(LS):Focal progression to bilateral tonic-clonic seizures(46.8%) was the most common seizure type in this group and the most common seizure type in the LS group(50.4%). The most common seizure type in ES group was focal seizure(47.8%). In addition,the proportion of negative emotions(65.2%) and mRS Score[2(3,4)]in ES group were higher than those in LS group[37.4%,2(2,3)],and the differences were statistically significant. Conclusion Cortical infarction,HT and NIHSS score ≥11 were independent risk factors for PSS. Focal progression to bilateral tonic-clonic seizures is the most common seizure type and is a common seizure type of LS,The common seizure type of early seizures is focal seizures,which are associated with negative mood and a worse prognosis.