Incidence and Associations of Poststroke Epilepsy The Prospective South London Stroke Register
Incidence and Associations of Poststroke Epilepsy The Prospective South London Stroke Register
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DOI：
10.1161/strokeaha.111.000220
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发表时间：
2013-03-01
期刊：
影响因子：
8.3
通讯作者：
Rudd, Anthony G.
中科院分区：
文献类型：
--
作者：
Graham, Neil S. N.;Crichton, Siobhan;Rudd, Anthony G.
背景和目的——描述中风后癫痫 (PSE) 的流行病学和关联，因为为临床医生提供信息和指导未来研究的证据有限。方法——数据是从基于人口的南伦敦中风登记册中收集的，记录了多种族市中心人口中的首次中风，最长随访时间为 12 年。自行填写的表格和访谈通知研究组织者癫痫诊断。使用 Kaplan-Meier 方法和 Cox 模型评估与社会人口学因素、临床特征、卒中亚型和严重程度标志物的关联。 结果：1995 年至 2007 年间，3300 名无癫痫病史的患者首次出现卒中，平均随访时间为 3.8 年。 213 名受试者 (6.4%) 出现 PSE。 3 个月、1 年、5 年和 10 年时的 PSE 发生率估计分别为 1.5%、3.5%、9.0% 和 12.4%。性别、种族和社会经济地位并不相关，但单变量分析显示，皮质位置标记（包括言语障碍、视力忽视和视野缺损）以及就诊时的中风严重程度指数（包括低格拉斯哥昏迷量表、失禁或 Barthel 指数功能差）与 PSE 相关。年轻年龄与 PSE 独立相关，根据 10 年估计，影响 85 岁患者的 10.7% (P=0.001)。 PSE 的独立预测因素还包括视觉忽视、语言障碍和中风亚型，特别是前循环梗死。构音障碍与发病率降低相关。结论-PSE 很常见，在急性期之外风险持续增加。年轻、皮质位置、较大病变和出血性病变是独立的预测因素。 （中风。2013；44：605-611。）
Background and Purpose-To describe the epidemiology and associations of poststroke epilepsy (PSE) because there is limited evidence to inform clinicians and guide future research.Methods-Data were collected from the population-based South London Stroke Register of first strokes in a multiethnic innercity population with a maximum follow-up of 12 years. Self-completed forms and interviews notified study organizers of epilepsy diagnosis. Kaplan-Meier methods and Cox models were used to assess associations with sociodemographic factors, clinical features, stroke subtype, and severity markers.Results-Three thousand three-hundred ten patients with no history of epilepsy presented with first stroke between 1995 and 2007, with a mean follow-up of 3.8 years. Two-hundred thirteen subjects (6.4%) had development of PSE. PSE incidence at 3 months and 1, 5, and 10 years were estimated at 1.5%, 3.5%, 9.0%, and 12.4%, respectively. Sex, ethnicity, and socioeconomic status were not associations, but markers of cortical location, including dysphasia, visual neglect, and field defect, along with stroke severity indices at presentation, including low Glasgow Coma Scale, incontinence, or poor function on Barthel Index, were associated with PSE on univariate analysis. Young age was independently associated with PSE, affecting 10.7% of patients aged 85 years (P=0.001) on 10-year estimates. Independent predictors of PSE also included visual neglect, dysphasia, and stroke subtype, particularly total anterior circulation infarcts. Dysarthria was associated with reduced incidence.Conclusions-PSE is common, with risk continuing to increase outside the acute phase. Young age, cortical location, larger lesions, and hemorrhagic lesions are independent predictors. (Stroke. 2013;44:605-611.)