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Prognosis of poststroke epilepsy

Artikel i vetenskaplig tidskrift
Författare Johan Zelano
Publicerad i Epilepsy and Behavior
ISSN 1525-5050
Publiceringsår 2019
Publicerad vid Institutionen för neurovetenskap och fysiologi
Språk en
Länkar dx.doi.org/10.1016/j.yebeh.2019.04....
Ämnesord Epilepsy, Rehabilitation, Stroke
Ämneskategorier Neurovetenskaper

Sammanfattning

This narrative review describes the literature on the impact of poststroke epilepsy (PSE)on stroke rehabilitation, quality of life (QoL), and mortality. Since severe stroke is a risk factor for PSE, it is not surprising that many studies report associations between PSE and poor functional outcome after stroke. However, some studies also report associations between PSE and outcome with multivariate analysis with adjustment for stroke severity, indicating that PSE may hamper rehabilitation. The mechanisms of such an effect remain unknown, and more studies are needed. Although the literature is heterogeneous, evidence is accumulating that PSE increases the risk of death. The majority of deaths are attributed to vascular disease, highlighting the importance of treating vascular risk in patients with PSE. Patients with PSE report poor QoL, especially if seizure freedom is not achieved. It is, therefore, worrying that although PSE is often considered easy to treat, many patients fail to achieve seizure freedom. Neurologists treating PSE should pursue seizure freedom in the same manner as all patients. With improved survival after stroke and raised ambitions in rehabilitation after stroke, the impact of PSE on life after stroke is a matter of growing importance. Future studies are needed on interventions that reduce the risk of vascular events in PSE. Qualitative studies describing obstacles experienced by patients with PSE are also currently lacking in the literature. This article is part of the Special Issue “Seizures & Stroke”. © 2019 Elsevier Inc.

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