Abstracts

RATIONALE: Epileptic seizures are a common occurrence following ischemic cerebrovascular accidents (ICA). They are the most prevalent cause of epilepsy in adult populations older than 45 years and stroke accounts for more than half of the newly diagnosed cases of epilepsy in the elderly. Seizures after ICA can occur during the acute phase of the insult or after an extremely variable latent period. Several experimental studies have reported the influences of gender and sex steroids on occurrence of spontaneous seizures. However, few clinical studies have addressed the influence of gender on remote symptomatic epilepsy. In the present study we evaluate, in patients with first-ever ICA, the influences exerted by both gender and age on the latent period needed to manifest the first remote epileptic seizure.
METHODS: Twenty-six (14 men) patients from private and outpatient clinic of the Federal University of Pernambuco Clinical Hospital-Recife were retrospectively evaluated. Information was obtained from medical records and from direct interviews with patients and their relatives. All patients presented at least one seizure episode after an ICA. In order to avoid the inclusion of acute- and subacute-induced seizures due to post-ischemic reversible changes (electrolytic, metabolic, edema, etc.), we decided to include only cases in which seizures occurred later than 30 days after the ICA episode.
RESULTS: The duration of the latent period (in months) was significantly longer in men when compared with women (19.1 [plusminus] 4.6 vs. 7.7 [plusminus] 1.7, respectively ; P=0.0389). In the male group, six out of 14 (42.9%) presented the latent period longer than 24 months, whereas all patients in the female group had a latent period shorter than 24 months (0/12, 0%; P=0.0171, Fisher[scquote]s exact test). When patients (both genders) were classified by categorical ages at the time of ICA (in years), no differences in the duration of latent period (in months) were found: 38[ndash]50y = 9 [plusminus] 3m; 51[ndash]60y = 18 [plusminus] 8m; 61[ndash]70y = 9 [plusminus] 3m; and 71[ndash]80y = 20 [plusminus] 8m, P = 0.3788, ANOVA.
CONCLUSIONS: The present study demonstrates that male patients present a longer latent period for the first remote epileptic seizure after an ICA than female patients. On the other hand, the age of the patient at the moment of ICA does not seem to interfere with the period needed to manifest post-stroke seizures.
[Supported by: CNPq, PRONEX and FAPESP (Proc. 99/11729-2, 00/12376-5); Brazil.]