Yıl: 2018 Cilt: 24 Sayı: 2 Sayfa Aralığı: 153 - 158 Metin Dili: Türkçe DOI: 10.4274/tnd.78545 İndeks Tarihi: 18-12-2018

İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi

Öz:
Amaç: İnmenin akut veya geç döneminde epileptik nöbetler görülebilir. Risk faktörleri genç yaş, erkek cinsiyet ve hemorajik transformasyon olarak saptanmıştır. Amacımız akut iskemik inme tanısı ile kliniğimizde takip edilen hastaların 1 yıllık nöbet geçirme oranını, etiyolojik faktörlerini araştırmak ve yüksek riskli grupları belirlemektir.Gereç ve Yöntem: Bu çalışmaya 01.01.2012 ile 01.01.2015 tarihleri arasında Eskişehir Osmangazi Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı’nda akut iskemik inme tanısı ile takip edilen ve 1 sene boyunca düzenli poliklinik kontrolleri gerçekleşmiş 299 hasta retrospektif olarak taranarak dahil edilmiştir.Bulgular: Çalışmamızda iskemik inmeli hastalarda trombolitik tedavinin inme sonrası nöbeti azalttığı (p=0,043), dekompresif kranyektomi (p=0,048) ve endovasküler tedavinin (p=0,032) ve kortikal tutulumun (p=0,003) inme sonrası nöbeti artırdığı bulunmuştur.Sonuç: Çalışmamıza göre kortikal tutulum varlığı, taburculuk modifiye Rankin Skalası skoru 4 ve 5 olması, endovasküler tedavi uygulanan majör damar oklüzyonu varlığı ve dekompresif kranyektomi yapılmış olması yüksek riskli grubu oluşturmaktadır. Yüksek riskli gruplarda çift kör plasebo ilaç çalışması yapılması mümkün olmadığından prospektif gözlemsel ilaç çalışmaları yapılabilir
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Klinik Nöroloji Nörolojik Bilimler Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme

Evaluation of Seizure After Stroke in Stroke Unit

Öz:
Objective: Patients with stroke may experience epileptic seizures as acute phase (usually defined as the first 15 days) or late phase complications. Risk factors are young age, male sex, cortical involvement and hemorrhagic transformation. Our aim was to investigate the etiologic factors and to determine the high-risk groups for the 1 year seizure rate of patients who are followed up in our clinic with a diagnosis of acute ischemic stroke. Materials and Methods: This study was included in a retrospective review of 299 patients who underwent regular out-patient clinic visits for 1 year followed by a diagnosis of acute ischemic stroke in the Department of Neurology at the Eskisehir Osmangazi University Faculty of Medicine between January 1st, 2012, and January 1st, 2015. Results: We found that thrombolytic therapy in patients with ischemic stroke decreased post-stroke seizure (p=0.043), whereas decompressive craniectomy (p=0.048), endovascular treatment (p=0.032), and cortical involvement (p=0.003) increased post-stroke seizures. Conclusion: According to our study, patients with cortical involvement, modified Rankin Scale score 4 and 5 at discharge, presence of major vascular occlusion treated with endovascular treatment, and those with decompressive craniectomy were high-risk groups. Prospective observational drug trials can be performed because double-blind placebo drug studies are not possible in high-risk groups
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Klinik Nöroloji Nörolojik Bilimler Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Van Tuijl JH, van Raak EP, de Krom MC, Lodder J, Aldenkamp AP. Early treatment after stroke for the prevention of late epileptic seizures: a report on the problems performing a randomized placebo-controlled double-blind trial aimed at anti-epileptogenesis. Seizure 2011;20:285-291.
  • Kwan J, Wood E. Antiepileptic drugs fort he primary and secondary prevention of seizures after stroke. Cohrane Database Syst Rev 2010:CD005398.
  • Santamarina E, Sueiras M, Toledo M, Guzman L, Torné R, Riveiro M, Quintana M, Salas Puig X, Sahuquillo J, Álvarez Sabín J. Epilepsy in patients with malignant middle cerebral artery infarcts and decompressive craniectomies. Epilepsy Res 2015;112:130-136.
  • Connolly ES, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, Hoh BL, Kirkness CJ, Naidech AM, Ogilvy CS, Patel AB, Thompson BG, Vespa P; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012;43:1711-1737.
  • Kittner SJ, Sharkness CM, Price TR, Plotnick GD, Dambrosia JM, Wolf PA, Mohr JP, Hier DB, Kase CS, Tuhrim S. Infarcts with a cardiac source of embolism in the NINCDS Stroke Data Bank: historical features. Neurology 1990;40:281-284.
  • Bladin CF, Alexandrov AV, Bellavance A, Bornstein N, Chambers B, Cote R, Lebrun L, Pirisi A, Norris JW. Seizures after stroke: a prospective multicenter study. Arch Neurol 2000;57:1617-1622.
  • Silverman IE, Restrepo L, Mathews GC. Poststroke seizures. Arch Neurol 2002;59:195-202.
  • Özkara Ç, Yılmaz N, Demir H, Küçükoglu H, Baybaş S. Serebrovasküler Hastalıklara Bağlı Gelişen Epilepsi Nöbetleri. Epilepsi 1995;1:23-27.
  • Kumral E, Ozkaya B, Sagduyu A, Sirin H, Vardarli E, Pehlivan M. The Ege Stroke Registry: a hospital-based study in the Aegean region, Izmir, Turkey. Analysis of 2,000 stroke patients. Cerebrovasc Dis 1998;8:278-288.
  • Killpatrick CJ, Davis SM, Tress BM, Rossiter SC, Hopper JL, Vandendriesen ML. Epileptic seizures in acute stroke. Arch Neurol 1990;47:157-160.
  • Zhang C, Wang X, Wang Y, Zhang JG, Hu W, Ge M, Zhang K, Shao X. Risk factors for poststroke seizures: A systematic revive and meta-analysis. Epilepsy Res 2014;108:1806-1816.
  • Lossius MI, Ronning OM, Mowinckel P, Gjerstad L. Incidences and predictors for poststroke epilepsy. A Prospective controlled trial. The Akershus stroke study. Eur J Neurol 2002;9:365-368.
  • Powers W, Derdeyn C, Biller J, Coffey CS, Hoh BL, Jauch EC, Johnston KC, Johnston SC, Khalessi AA, Kidwell CS, Meschia JF, Ovbiagele B, Yavagal DR; American Heart Association Stroke Council. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2015;46:3020-3035.
  • Wahlgren N, Moreira T, Michel P, Steiner T, Jansen O, Cognard C, Mattle HP, van Zwam W, Holmin S, Tatlisumak T, Petersson J, Caso V, Hacke W, Mazighi M, Arnold M, Fischer U, Szikora I, Pierot L, Fiehler J, Gralla J, Fazekas F, Lees KR; ESO-KSU, ESO, ESMINT, ESNR and EAN. Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN. Int J Stroke 2016;11:134-147.
  • Hacke W, Kaste M, Bluhmki E, Brozman M, Davalos A, Guidetti D, Larrue V, Lees KR, Medeghri Z, Machnig T, Schneider D, von Kummer R, Walhlgren N, Toni D. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 2008;359:1317-1329.
  • The ATLANTIS, ECASS, and NINDS rt-PA Study Group Investigators. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004;363:768-774.
  • The National Institute of Neurological Disorders and Stroke tPA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333:1581-1587.
  • De Reuck J, Van Maele G. Acute ischemic stroke treatment and the occurrence of seizures. Clin Neurol Neurosurg 2010;112:328-331.
  • Alvares V, Andrea O, Papavasileiou V, Michael P. Acute seizures in acute ischemic stroke: does thrombolysis have a role to play. J Neurol 2013;260:55-61.
  • Rodan LH, Aviv RI, Sahlas DJ, Murray BJ, Gladstone JP, Gladstone DJ. Seizures during stroke thrombolysis heralding dramatic neurologic recovery. Neurology 2006;67:2048-2049.
  • Hafeez F, Razzaq MA, Levine RL, Ramirez MA. Reperfusion seizures: a manifestation of cerebral reperfusion injury after administration of recombinant tissue plasminogen activator for ischemic stroke. J Stroke Cerebrovasc Dis 2007;16:273-277.
  • Tsirka SE, Gualandris A, Amaral DG, Strickland S. Excitotoxin-induced neuronal degeneration and seizure are mediated by tissue plasminogen activator. Nature 1995;377:340-344.
  • Yepes M, Sandkvist M, Coleman TA, Moore E, Wu JY, Mitola D, Bugge TH, Lawrence DA. Regulation of seizure spreading by neuroserpin and tissue-type plasminogen activator is plasminogen-independent. J Clin Invest 2002;109:1571-1578.
  • Qian Z, Gilbert ME, Colicos MA, Kandel ER, Kuhl D. Tissue plasminogen activator is induced as an immediate-early gene during seizure, kindling and long-term potentiation. Nature 1993;361:453-457.
  • Yepes M, Roussel BD, Ali C, Vivien D. Tissue-type plasminogen activator in the ischemic brain: more than a thrombolytic. Trends Neurosci 2009;32:48-55.
  • Demir T, Aslan K, Balal M, Bozdemir H. Clinical features of postroke epilepsy and relationship with prognosis. [Article in Turkish] Epilepsi 2013;19:121-126.
  • Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke 1988;19:1083-1092.
  • Arboix A, Garcı´a-Eroles L, Massons JB, Oliveres M, Comes E. Predictive factors of early seizures after acute cerebro- vascular disease. Stroke 1997;28:1590-1594.
  • Giroud M, Gras P, Fayolle H, André N, Soichot P, Dumas R. Early seizures after acute stroke: a study of 1,640 cases. Epilepsia 1994;35:959-964.
  • Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Epileptic seizures after a first stroke: Oxfordshire Community Stroke Project. BMJ 1997;315:1582-1587.
  • So EL, Annegers JF, Hauser WA, O’Brien PC, Whisnant JP. Population-based study of seizure disorders after cerebral infarction. Neurology 1996;46:385-388.
  • Forsgren L, Burcht G, Erikson S, Bergmark L. Incidence and clinical characterization of unprovoked seizures in adults: a prospective populations-based study. Epilepsia 1996;37:224-229.
  • Ferro JM, Pinto F. Poststroke epilepsy: epidemiology, pathophysiology and management. Drugs Aging 2004;21:639-653.
APA DİNÇ Y, TEKGÖL UZUNER G, EMİR B (2018). İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. , 153 - 158. 10.4274/tnd.78545
Chicago DİNÇ Yasemin,TEKGÖL UZUNER GÜLNUR,EMİR Büşra İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. (2018): 153 - 158. 10.4274/tnd.78545
MLA DİNÇ Yasemin,TEKGÖL UZUNER GÜLNUR,EMİR Büşra İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. , 2018, ss.153 - 158. 10.4274/tnd.78545
AMA DİNÇ Y,TEKGÖL UZUNER G,EMİR B İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. . 2018; 153 - 158. 10.4274/tnd.78545
Vancouver DİNÇ Y,TEKGÖL UZUNER G,EMİR B İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. . 2018; 153 - 158. 10.4274/tnd.78545
IEEE DİNÇ Y,TEKGÖL UZUNER G,EMİR B "İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi." , ss.153 - 158, 2018. 10.4274/tnd.78545
ISNAD DİNÇ, Yasemin vd. "İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi". (2018), 153-158. https://doi.org/10.4274/tnd.78545
APA DİNÇ Y, TEKGÖL UZUNER G, EMİR B (2018). İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. Türk Nöroloji Dergisi, 24(2), 153 - 158. 10.4274/tnd.78545
Chicago DİNÇ Yasemin,TEKGÖL UZUNER GÜLNUR,EMİR Büşra İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. Türk Nöroloji Dergisi 24, no.2 (2018): 153 - 158. 10.4274/tnd.78545
MLA DİNÇ Yasemin,TEKGÖL UZUNER GÜLNUR,EMİR Büşra İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. Türk Nöroloji Dergisi, vol.24, no.2, 2018, ss.153 - 158. 10.4274/tnd.78545
AMA DİNÇ Y,TEKGÖL UZUNER G,EMİR B İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. Türk Nöroloji Dergisi. 2018; 24(2): 153 - 158. 10.4274/tnd.78545
Vancouver DİNÇ Y,TEKGÖL UZUNER G,EMİR B İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi. Türk Nöroloji Dergisi. 2018; 24(2): 153 - 158. 10.4274/tnd.78545
IEEE DİNÇ Y,TEKGÖL UZUNER G,EMİR B "İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi." Türk Nöroloji Dergisi, 24, ss.153 - 158, 2018. 10.4274/tnd.78545
ISNAD DİNÇ, Yasemin vd. "İnme Merkezinde İnme Sonrası Nöbetin Değerlendirilmesi". Türk Nöroloji Dergisi 24/2 (2018), 153-158. https://doi.org/10.4274/tnd.78545