Associations of small vessel disease and acute symptomatic seizures in ischemic stroke patients

Alain Lekoubou, Paddy Ssentongo, Jonathon Maffie, Kunal Debroy, Michelle Kwon, Clever Nguyen, Matthew Pelton, Benjamin Watt, Justin Ceasar, Nadia Dinunno, Vivek Satyasi, Andre Pascal Kengne, Leonardo Bonilha, Vernon M. Chinchilli

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Abstract

Background and purpose: Cerebral microbleeds (CMBs), markers of small vessel disease are frequent in ischemic stroke, yet the association with acute symptomatic seizures (ASS) has not been well characterized. Methods: A retrospective cohort of hospitalized patients with anterior circulation ischemic stroke. The association of CMBs with acute symptomatic seizures was assessed using a logistic regression model and causal mediation analysis. Results: Of 381 patients, 17 developed seizures. Compared with patients without CMBs, those with CMBs had a three-fold higher unadjusted odds of seizures (unadjusted OR: 3.84, 95% 1.16–12.71, p = 0.027). After adjusting for confounders such as stroke severity, cortical infarct location, and hemorrhagic transformation, the association between CMBs and ASS was attenuated (adjusted OR: 3.11, 95%CI: 0.74–11.03, p = 0.09). The association was not mediated by stroke severity. Conclusion: In this cohort of hospitalized patients with anterior circulation ischemic stroke, CMBs were more likely to be found in patients with ASS than those without ASS, an association that was attenuated when accounting for stroke severity, cortical infarct location, and hemorrhagic transformation. Evaluation of the long-term risk of seizures associated with CMBs and other markers of small vessel disease is warranted.

Original languageEnglish (US)
Article number109233
JournalEpilepsy and Behavior
Volume145
DOIs
StatePublished - Aug 2023

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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