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      Exames subsidiários preditivos de crises epilépticas após acidente vascular cerebral isquêmico Translated title: Epileptic seizures after ischemic stroke: are there any preditive laboratory test?

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          Abstract

          Na tentativa de detectar fatores preditivos para ocorrência de crises epilépticas após acidente vascular cerebral isquêmico (AVCI), estudamos exames laboratoriais de glicemia, hematócrito, colesterol total e frações e triglicérides, além de eletrocardiograma, eletrencefalograma (EEG), líquido cefalorraquiano e tomografia computadorizada do crânio (TC) em 35 pacientes com AVCI que evoluíram com crises epilépticas após pelo menos 24 horas a partir da instalação do AVCI (grupo 1 ou G1), que foram comparados a 35 pacientes com AVCI que evoluíram sem crises epilépticas (grupo 2 ou G2). Encontramos significância na análise EEG na comparação dos grupos, sendo a alteração mais freqüente o alentecimento focai da atividade elétrica cerebral no G1. A presença de lesão extensa na TC também associou-se ao G1. A associação de EEG anormal e lesão extensa na TC pode ser considerado elemento preditivo para ocorrência de crises epilépticas após AVCI com coeficiente de concordância de 34%. Os demais exames estudados não mostraram significância na comparação entre os grupos G1 e G2.

          Translated abstract

          We studied subsidiary laboratorial tests such as serum glucose, red blood cell count, total cholesterol, HDL and LDL cholesterol and triglycerides, eletrocardiogram, eletroencephalogram (EEG), cerebrospinal fluid, and CT scan of 35 patients with cerebral infarction who developed epileptic seizures (group 1 or G1), and compared them to a group of 35 patients who had cerebral infarction but have not developed epileptic seizures (group 2 or G2). The EEG analysis showed significance in the comparison between the groups; focal lentification of the electrical cerebral activity was the most frequent abnormality found in G1. Extensive infarcts were also more frequent in G1. The association of abnormal EEG and extensive lesion on CT may be considered a preditive factor for occurrence of epileptic seizures after cerebral infarction. The analysis of the other tests showed no significance on the comparison between the groups.

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          Most cited references30

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          The Measurement of Observer Agreement for Categorical Data

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            The frequency, characteristics and prognosis of epileptic seizures at the onset of stroke.

            In a series of 230 patients admitted to hospital with a stroke, the frequency and significance of epileptic seizures at onset was assessed. Thirteen (5.7%) suffered single or multiple witnessed seizures at the onset of their stroke. Seizures were evenly distributed among all pathological stroke sub-types but were restricted to lesions in the carotid artery territory. They indicated a poorer prognosis over the first 2 days. Six of the 13 presenting with stroke and seizures had prior seizures and, if they survived, continued to have fits. The five patients surviving with stroke and a first seizure were all fit-free after 30 months follow-up.
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              Epilepsy after stroke

              Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients with other severe diseases. Cerebral angiography, CT, and EEG were performed in all patients. The patients were followed clinically for 2 to 4 years. Seven patients (9%) developed epilepsy. Of 23 patients with lesions involving the cortex, 6 (26%) developed epilepsy. Of 54 patients in whom the cortex was not involved, only 1 (2%) developed epilepsy. Patients with persisting paresis and cortical involvement seem to be at particularly high risk of developing epilepsy, as 50% of such patients (6 of 12) developed the disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                1997
                : 55
                : 1
                : 39-45
                Affiliations
                [1 ] Universidade Federal de São Paulo Brazil
                Article
                S0004-282X1997000100007
                10.1590/S0004-282X1997000100007
                df938eda-7d82-4667-84b4-0825d9f5c66f

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                stroke,cerebral infarction,epilepsy,epileptic seizures,eletroencephalography,tomography,doença cerebrovascular,infarto cerebral,epilepsia,eletrencefalograma,tomografia

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