Intravenous thrombolysis or mechanical thrombectomy do not increase risk of acute symptomatic seizures in patients with ischemic stroke

  • Recent data have suggested that performing recanalizing therapies in ischemic stroke might lead to an increased risk of acute symptomatic seizures. This applies to both intravenous thrombolysis and mechanical thrombectomy. We therefore determined the frequency of acute symptomatic seizures attributable to these two recanalization therapies using a large, population-based stroke registry in Central Europe. We performed two matched 1:1 case–control analyses. In both analyses, patients were matched for age, stroke severity on admission and pre-stroke functional status. The first analysis compared patients treated with intravenous thrombolysis to a non-recanalization control group. To isolate the effect of mechanical thrombectomy, we compared patients with both mechanical thrombectomy and intravenous thrombolysis to those with only intravenous thrombolysis treatment in a second analysis. From 135,117 patients in the database, 13,356 patients treated with only intravenous thrombolysis, and 1013 patients treated with both intravenous thrombolysis and mechanical thrombectomy were each matched to an equivalent number of controls. Patients with intravenous thrombolysis did not suffer from clinically apparent acute symptomatic seizures significantly more often than non-recanalized patients (treatment = 199; 1.5% vs. control = 237; 1.8%, p = 0.07). Mechanical thrombectomy in addition to intravenous thrombolysis also was not associated with an increased risk of acute symptomatic seizures, as the same number of patients suffered from seizures in the treatment and control group (both n = 17; 1.7%, p = 1). In a large population-based stroke registry, the frequency of clinically apparent acute symptomatic seizures was not increased in patients who received either intravenous thrombolysis alone or in conjunction with mechanical thrombectomy.

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Author:Johann Philipp ZöllnerORCiDGND, Björn Misselwitz, Thomas Mauroschat, Christian RothORCiD, Helmuth SteinmetzORCiDGND, Felix RosenowORCiDGND, Adam StrzelczykORCiDGND
Parent Title (English):Scientific reports
Publisher:Macmillan Publishers Limited, part of Springer Nature
Place of publication:[London]
Document Type:Article
Date of Publication (online):2020/12/03
Date of first Publication:2020/12/03
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/10/13
Tag:Cerebrovascular disorders; Epilepsy; Stroke
Issue:art. 21083
Article Number:21083
Page Number:7
First Page:1
Last Page:7
Open Access funding enabled and organized by Projekt DEAL. This study was supported by a LOEWE Grant from the State of Hessen to F.R. and A.S. (Teilprojekte 1/4) for the “Center for Personalized Translational Epilepsy Research” (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany.
Data are available upon request by qualified researchers from the Geschäftsstelle Qualitätssicherung Hessen (GQH), pending certain prerequisites.
All code used is available as part of SPSS, version 26 (IBM Corp., Armonk, NY, USA).
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International