20 Feb Long Term Risk of Seizures After Stroke Remains High
MedicalResearch.com Interview with:
Alexander Merkler, MD
Fellow in neuro critical care
Weill Cornell Medical College and
New York-Presbyterian Hospital, New York
Medical Research: What is the background for this study? What are the main findings?
Dr. Merkler: Patients with stroke often ask about what type of problems they may expect in the future. As neurologists, we often warm our patients about the risk for recurrent stroke, infections, clots, eating difficulty, and depression. Although seizures are a well-known complication of stroke, there was little data regarding the long-term rate of seizures in patients who have a stroke. Therefore, we sought to evaluate the long-term risk of seizures following stroke in order to better advise physicians and patients on the likelihood of developing seizures after suffering a stroke. We identified over 600,000 patients with stroke and found that the rate of seizures after stroke is high – 15.3% of all patients with stroke will develop seizures. Patients who have hemorrhagic stroke face an even higher rate of seizures – 24% of patients with hemorrhagic type stroke will develop seizures. The rate of seizures after ischemic stroke was significantly higher than previous literature – 13.5% of patients with an ischemic stroke had a seizure in our study.
Medical Research: What should clinicians and patients take away from your report?
Dr. Merkler: Both patients and physicians should be aware of the high long-term risk of seizures after stroke. Physician should be aware that seizure are not an uncommon consequence of stroke and should counsel patients with stroke about the possibility of seizures. Patients with stroke should be aware they may develop seizures and should be counseled on common symptoms or signs of seizures.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Merkler: This project has shown that seizures are a common complication of stroke. We have also learned that patients with hemorrhagic type stroke are at an even higher risk of developing seizures. However, we don’t know whether there are other factors that may increase the risk of seizures and thereby help further risk stratify patients with stroke into who will develop seizures and who will not. In addition, we do not know whether use of prophylactic antiepileptic medications would be useful in patients who are at high risk for seizures, such as those patients with hemorrhagic stroke. Future research should be focused on identifying which types of stroke put patients at highest risk for developing seizures and assessing whether the use of preventive antiepileptic therapy could be useful in patients with a very high risk of having seizures.
Alexander Merkler, MD (2016). Long Term Risk of Seizures After Stroke Remains High