Abstracts

Rationale: In the last years, thrombolytic therapy has changed the management of acute ischemic stroke. Randomized clinical studies have demonstrated that intravenous thrombolysis with tissue plasminogen activator improves functional outcomes. Our aim is evaluate if intravenous (IV) treatment with rt-PA influences in appearance of symptomatic epileptic seizures after acute cerebral infarct.Methods: Observational case-control study (1:3) of patients with a non-lacunar acute cerebral infarct, seen in a Stroke Unit (2008-2009). Cases: patients treated with IV rt-PA. Controls: patients not treated with IV rt-PA, paired with cases according to severity (NIHSS), and cerebral artery involved. Patients with previous epilepsy, brainstem infarct, or neurointerventionist treatment, were excluded. Variables: basal data, stroke severity (NIHSS), etiology, involvement of cerebral cortex and appearance of early (<7 days) or late (>7 days) symptomatic seizures.Results: 147 patients, 49 cases. Mean age was less in cases than in controls (66.51 Vs 72.78; p=0.007). Proportion of males was similar (57.1% Vs 44.9%; p=0.162). Cases had more frequently uncommon etiology infarcts (14.3% Vs 4.1%; p=0.042). There were no differences in vascular risk factors, previous treatment, nor cerebral cortex involvement. Early and late seizures were similar between cases and controls (6.1% Vs 7.1%, and 10.2% Vs 7.1%, respectively; p=NS). Hemorrhagic transformation was the only independient predictor factor in early (OR 5.69; CI 90% 1.44-22.45) and late (OR 3.71; CI 95% 1-13.76) seizures, adjusted by age, sex, NIHSS, cerebral cortex involvement and IV rt-PA.Conclusions: Treatment with IV rt-PA does not influence in the appearance of symptomatic seizures after an acute cerebral infarct. Hemorrhagic transformation is a predictor factor of such seizures.