EPILEPSY IN PATIENTS WITH ACUTE AND CHRONIC CEREBRAL ISCHEMIA
Background. Epilepsy is one of the most common diseases of the nervous system. Cerebral ischemia is an important risk factor for the development of seizures.
The purpose of the study: to study the clinical, MRI, functional and hemodynamic characteristics in patients with cerebral ischemia with seizures.
Materials and methods: to achieve this goal a total of 772 patients suffering from acute and chronic disorders of cerebral circulation (265 stroke patients and 174 patients with chronic cerebral ischemia experienced epileptic seizures, 203 stroke patients and 130 patients with chronic cerebral ischemia experienced no epileptic seizures) were under integral medical supervision. Patients in the control group were matched with the study group in age, clinical characteristics, pathogenic subtypes of stroke and stage of chronic cerebral ischemia.
Neurological examination was carried out by the usual method. Visualization of brain structures was carried out with the help of magnetic resonance imaging (MRI) (1.5 Tesla). The functional state of the cerebral hemispheres was assessed by electroencephalogram (EEG). In addition, the extracranial and transcranial duplex sonography was performed.
Results: in patients with ischemic stroke and in patients with chronic cerebral ischemia focal seizures prevailed, the highest rate of their development has been between the ages of 50 to 69 years. Patients with seizures had a significant prevalence of symptoms caused by a violation of cerebral circulation in vertebro-basilar basin. Focuses abnormal EEG activity prevailed in the temporal region and in the left hemisphere of the brain. According to the MRI of the brain cortical and subcortical ischemic lesions, increased cerebrospinal fluid spaces prevailed in patients with seizures. Stenoses of major cerebral arteries were also more common in patients with seizures.
Conclusions. The study identified risk factors for epileptic seizures in patients with cerebral ischemia.
Dina R. Khasanova1, 2, http://orcid.org/0000-0002-8825-2346
Tatyana V. Danilova1, 2, http://orcid.org/0000-0001-6926-6155
1 Kazan State Medical University,
Department of Neurology and Neurosurgery, Kazan, Russia
2 Interregional clinical diagnostic center,
Neurological department for patients with stroke, Kazan, Russia
1. Аванцини Дж. Эпилепсия – медико-социальные аспекты, диагностика и лечение: материалы международной конференции // Журн. неврологии и психиатрии. 2005. № 8. С.57-59.
2. Визило Т.Л., Михайлов В.П., Власова И.В. Клиническое значение оценки церебрального кровотока при дисциркуляторной атеросклеротической энцефалопатии // Бюллетень академии медицинских наук СО РАН. 2002. Вып.11. С.16—20.
3. Генералов В.О., Федин А.И., Садыков Т.Р. Клинико-энцефалографический анализ парциальных вторично-генерализованных приступов // Эпилепсия: прил. к журн. неврология и психиатрия. 2009. № 11. С.65-68.
4. Генералов В.О. Эпилепсия и структурные повреждения мозга: автореф. дис. … д-ра мед. наук. Москва, 2010. 43с.
5. Гехт А.Б., Куркина И.В., Локшина О.Б., Лаврова Д.И., Шпак А.А., Гагаева Т.Ю., Тлашпокова Л.Б., Пьяных С.Е., Лебедева А.В. Эпидемиологическое исследование эпилепсии в Москве // Журнал неврологии и психиатрии. 1999. №10. С. 4-8.
6. Гехт А.Б., Лебедева А.В., Рулева З.С., Локшина О.Б., Тлапшокова Л.Б., Митрохина Т.В. Эпилепсия у больных инсультом // Российский медицинский журнал. 2000. №2. С. 14-17.
7. Гехт А.Б. Эпилепсия у пожилых // Журнал неврологии и психиатрии. 2005. №11. С. 66-67.
8. Карлов В.А. Эпилепсия у детей и взрослых женщин и мужчин. М: Медицина. 2010. 720 с.
9. Шнайдер Н.А., Чацкая А.В., Дмитренко Д.В., Шевченко О.И. Постинсультная эпилепсия // Международный неврологический журнал. 2007. № 4. С.3-7.
10. Alberti A, Paciaroni M, Caso V, Venti M, Palmerini F, Agnelli G. Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome. Vascular Health and Risk Management 2008: 4(3) 715 – 720.
11. Arboix A., Comes E., Massons J. et al. Prognostic value of very early seizure for in-hospitality mortality in atherotrombotic infarction. Eur Neurol. 2003; 50: 350 – 355.
12. Barolin G.S., Sherzer E. Epileptische Anfalle bei Apoplektikern // Wein Nervenh. 1962. №20. P. 35-4714.
13. Bladin C.F., Alexandrov A.V., Bellavance A., Bornstein N., Chambers B., Cote R., Lebrun L., Pirisi A., Norris J.W. Seizures after stroke: a prospective multicenter study. Arch Neurol. 2000; 57: 1617 – 1622.
14. Bryniarska D. Etiological spectrum of symptomatic epilepsy in adults / D. Bryniarska, E. Zakrzewska // Przegl. Lek. 2001. Vol.58, № 9. Р.839-335.
15. Camilo O., Darry D., Goldstein B. Seizures and Epilepsy after Ischemic Stroke // Stroke. – 2004. №7 Р.1769-1775.
16. Giroud M., Gras P., Fayolle H., Andre N., Soichot P., Dumas R. Early seizures after acute stroke: a study of 1640 cases. Epilepsia. 1994; 35: 959 – 964.
17. Kilpatrick C.J., Davis S.M., Tress B.M., Rossiter S.C., Hopper J.L., Vandendriesen M.L. Epileptic seizures in acute stroke. Arch Neurol. 1990; 47: 157 – 160.
18. Knake S. Status epilepticus after stroke in associated with increased long-term fatality / S. Knake, J. Rochon, S. Fleischer // Epilepsia. 2006. Vol.47. P.2020—2026.
19. Lami C., Domigo V., Semah F., Arquizan C., Trystram, Coste J., Mas J.L. Early and late sizures after cryptogenic ischemic stroke in young adults. Neurology 2003; 60: 400 – 404.
20. Reuck J, Van Maele G. Acute ischemic stroke treatment and the occurrence of seizures. Clinical neurology and neurosurgery. 2010; 112(4): 328 – 331.
21. Sander J.W. The epidemiology of epilepsy revisited / J.W. Sander // Current Opinion in Neurology. 2003. Vol.16. P.165—170.
22. Siddiqi S.A., Hashmi M., Khan F., Siddiqui K.A. Clinical spectrum of post-stroke seizures. J. Coll. Physicians Sung Pak. 2011; 21(4): 214-218.
References:
1. Avantsini Dzh. Epilepsiya – mediko-sotsial'nye aspekty, diagnostika i lechenie: materialy mezhdunar. konf. [Epilepsy - medical and social aspects, diagnosis and treatment: Proceedings of the International Conference]. Zhurn. nevrologii i psikhiatrii [Journal of Neurology and Psychiatry]. 2005. № 8. pp.57-59. [in Russian].
2. Vizilo T.L., Mikhailov V.P., Vlasova I.V. Klinicheskoe znachenie otsenki tserebral'nogo krovotoka pri distsirkulyatornoi ateroskleroticheskoi entsefalopatii [The clinical significance of cerebral blood flow assessment in dyscirculatory atherosclerotic encephalopathy]. Byulleten' akademii meditsinskikh nauk SO RAN [Bulletin of the Academy of Medical Sciences of the SB RAS.]. 2002. № 11. pp.16-20. [in Russian].
3. Generalov V.O., Fedin A.I., Sadykov T.R. Kliniko-entsefalograficheskii analiz partsial'nykh vtorichno-generalizovannykh pristupov [Clinical and Electroencephalographic analysis of partial secondary generalized seizures]. Epilepsiya: pril. k zhurn. nevrologiya i psikhiatriya [Epilepsy: adj. to Journal of neurology and psychiatry]. 2009. № 11. pp.65-68. [in Russian].
4. Generalov V.O. Epilepsiya i strukturnye povrezhdeniya mozga: avtoref. dis. … d-ra med. nauk. [Epilepsy and structural damage of the brain: Author. Dis. ... Dr. med. Sciences]. Moskva, 2010. 43p. [in Russian].
5. Gekht A.B., Kurkina I.V., Lokshina O.B., Lavrova D.I., Shpak A.A., Gagaeva T.Yu., Tlashpokova L.B., P'yanykh S.E., Lebedeva A.V. Epidemiologicheskoe issledovanie epilepsii v Moskve [Epidemiological survey of epilepsy in Moscow]. Zhurnal nevrologii i psikhiatrii [Journal of Neurology and Psychiatry]. 1999. №10. pp. 4-8. [in Russian].
6. Gekht A.B., Lebedeva A.V., Ruleva Z.S., Lokshina O.B., Tlapshokova L.B., Mitrokhina T.V. Epilepsiya u bol'nykh insul'tom [Epilepsy in stroke patients]. Rossiiskii meditsinskii zhurnal [Russian Medical Journal]. 2000. №2. pp. 14-17. [in Russian].
7. Gekht A.B. Epilepsiya u pozhilykh [Epilepsy in elderly]. Zhurnal nevrologii i psikhiatrii [Journal of Neurology and Psychiatry]. 2005, 11. pp. 66-67. [in Russian].
8. Karlov V.A. Epilepsiya u detei i vzroslykh zhenshchin i muzhchin [Epilepsy in children and adult women and men]. M: Medicine , 2010, 720 p. [in Russian].
9. Shnaider N.A., Chatskaya A.V., Dmitrenko D.V., Shevchenko O.I. Postinsul'tnaya epilepsiya [Post-stroke epilepsy]. Mezhdunarodnyi nevrologicheskii zhurnal [International Journal of Neurology]. 2007. № 4. pp.3-7. [in Russian].
10. Alberti A, Paciaroni M, Caso V, Venti M, Palmerini F, Agnelli G. Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome. Vascular Health and Risk Management. 2008: 4(3) 715 – 720.
11. Arboix A., Comes E., Massons J. et al. Prognostic value of very early seizure for in-hospitality mortality in atherotrombotic infarction. Eur Neurol. 2003; 50: 350 – 355.
12. Barolin G.S., Sherzer E. Epileptische Anfalle bei Apoplektikern // Wein Nervenh. 1962. №20. P. 35-4714.
13. Bladin C.F., Alexandrov A.V., Bellavance A., Bornstein N., Chambers B., Cote R., Lebrun L., Pirisi A., Norris J.W. Seizures after stroke: a prospective multicenter study. Arch Neurol. 2000; 57: 1617 – 1622.
14. Bryniarska, D. Etiological spectrum of symptomatic epilepsy in adults / D. Bryniarska, E. Zakrzewska. Przegl. Lek. 2001. Vol.58, № 9. Р.839-335.
15. Camilo O., Darry D., Goldstein B. Seizures and Epilepsy after Ischemic Stroke. Stroke. – 2004. №7 Р.1769-1775.
16. Giroud M., Gras P., Fayolle H., Andre N., Soichot P., Dumas R. Early seizures after acute stroke: a study of 1640 cases. Epilepsia. 1994; 35: 959 – 964.
17. Kilpatrick C.J., Davis S.M., Tress B.M., Rossiter S.C., Hopper J.L., Vandendriesen M.L. Epileptic seizures in acute stroke. Arch Neurol. 1990; 47: 157 – 160.
18. Knake, S. Status epilepticus after stroke in associated with increased long-term fatality / S. Knake, J. Rochon, S. Fleischer. Epilepsia. 2006. Vol.47. P.2020-2026.
19. Lami C., Domigo V., Semah F., Arquizan C., Trystram, Coste J., Mas JL. Early and late sizures after cryptogenic ischemic stroke in young adults. Neurology 2003; 60: 400 – 404.
20. Reuck J, Van Maele G. Acute ischemic stroke treatment and the occurrence of seizures. Clinical neurology and neurosurgery. 2010; 112(4): 328 – 331.
21. Sander, J.W. The epidemiology of epilepsy revisited. Current Opinion in Neurology. 2003. Vol.16. P.165—170.
22. Siddiqi S.A., Hashmi M., Khan F., Siddiqui K.A. Clinical spectrum of post-stroke seizures. J. Coll. Physicians Sung Pak. 2011; 21(4): 214-218.Bibliography link
Хасанова Д.Р., Данилова Т.В. Эпилепсия при острой и хронической церебральной ишемии / / Наука и Здравоохранение. 2016. №2. С. 70-83.
Khasanova D.R., Danilova T.V. Epilepsy in patients with acute and chronic cerebral ischemia. Nauka i Zdravookhranenie [Science & Healthcare]. 2016, 2, pp. 70-83.
Хасанова Д.Р., Данилова Т.В. Жіті және созылмалы церебралды ишемия кезіндегі эпилепсия / / Ғылым және Денсаулық сақтау. 2016. №2. Б. 70-83.