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dc.contributor.authorNaylor, J
dc.contributor.authorThevathasan, A
dc.contributor.authorChurilov, L
dc.contributor.authorGuo, R
dc.contributor.authorXiong, Y
dc.contributor.authorKoome, M
dc.contributor.authorChen, Z
dc.contributor.authorChen, Z
dc.contributor.authorLiu, X
dc.contributor.authorKwan, P
dc.contributor.authorCampbell, BCV
dc.date.accessioned2020-12-17T03:46:08Z
dc.date.available2020-12-17T03:46:08Z
dc.date.issued2018-05-03
dc.identifierpii: 10.1186/s12883-018-1064-x
dc.identifier.citationNaylor, J., Thevathasan, A., Churilov, L., Guo, R., Xiong, Y., Koome, M., Chen, Z., Chen, Z., Liu, X., Kwan, P. & Campbell, B. C. V. (2018). Association between different acute stroke therapies and development of post stroke seizures. BMC NEUROLOGY, 18 (1), https://doi.org/10.1186/s12883-018-1064-x.
dc.identifier.issn1471-2377
dc.identifier.urihttp://hdl.handle.net/11343/255022
dc.description.abstractBACKGROUND: Epilepsy is a major complication of stroke. We aimed to establish whether there is an association between intravenous thrombolysis, intra-arterial thrombolysis and post stroke seizure (PSS) development. Improved understanding of the relationship between reperfusion therapies and seizure development may improve post-stroke monitoring and follow-up. METHODS: This was a retrospective, multicentre cohort study conducted at the Royal Melbourne Hospital and Jingling Hospital Nanjing. We included patients with anterior circulation ischemic stroke admitted 2008-2015. Patients were divided into four treatment groups 1. IV-tPA only, 2. Intra-arterial therapies (IAT) only, 3. IAT + IV-tPA and 4. stroke unit care only (i.e. no IV-tPA or IAT). To assess the association between type of reperfusion treatment and seizure incidence we used multivariable logistic regression models adjusted for age, stroke severity, 3-month functional outcome and prognostic factors. RESULTS: There were 1375 stroke unit care-only patients, of whom 28 (2%) developed PSS. There were 363 patients who received only IV-tPA, of whom 21 (5.8%) developed PSS. There were 93 patients who received IAT only, of whom 12 (12.9%) developed PSS and 112 that received both IV-tPA + IAT, of which 5 (4.5%) developed PSS. All reperfusion treatments were associated with seizure development compared to stroke unit care-only patients: IV-tPA only adjusted odds ratio (aOR) 3.7, 95%CI 1.8-7.4, p < 0.0001; IAT aOR 5.5, 95%CI 2.1-14.3, p < 0.0001, IAT + IV-tPA aOR 3.4, 95% CI 0.98-11.8, p = 0.05. These aORs did not differ significantly between treatment groups (IV-tPA + IAT versus IV-tPA p = 0.89, IV-tPA + IAT versus IAT, p = 0.44). CONCLUSIONS: Patients receiving thrombolytic or intra-arterial reperfusion therapies for acute ischemic stroke are at higher risk of epilepsy and may benefit from longer follow-up. No evidence for an additive or synergistic effect of treatment modality on seizure development was found.
dc.languageEnglish
dc.publisherBIOMED CENTRAL LTD
dc.titleAssociation between different acute stroke therapies and development of post stroke seizures
dc.typeJournal Article
dc.identifier.doi10.1186/s12883-018-1064-x
melbourne.affiliation.departmentMedicine and Radiology
melbourne.source.titleBMC Neurology
melbourne.source.volume18
melbourne.source.issue1
dc.rights.licenseCC BY
melbourne.elementsid1328714
melbourne.contributor.authorChurilov, Leonid
melbourne.contributor.authorNaylor, Jillian
melbourne.contributor.authorKwan, Patrick
melbourne.contributor.authorCampbell, Bruce
dc.identifier.eissn1471-2377
melbourne.accessrightsOpen Access


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