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Does treatment with t-PA increase the risk of developing epilepsy after stroke?

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Abstract

Patients suffering from ischemic stroke carry an enhanced risk of developing secondary epilepsy. We sought to clarify whether thrombolytic treatment with recombinant tissue plasminogen activator (t-PA) is independently associated with post-stroke epilepsy (PSE). In this observational study, data from 302 stroke patients treated at a single academic neurological department were analyzed retrospectively. Median follow-up was 42 months (maximum 80). Variables included presence of comorbidity, stroke severity, neurological presentation, complications, infarct characteristics, and treatment with t-PA. After univariate analyses, a multivariate analysis was performed to create a model of factors that were significantly associated with PSE, including treatment with t-PA. 13.9 % of patients developed PSE during follow-up. Multivariate analysis identified 5 independent factors for PSE: low Barthel Index at discharge; hemianopia; infection acquired during the hospital stay; involvement of the temporal lobe; involvement of the perirolandic cortex. While the incidence of PSE was higher in patients treated with t-PA (20.6 vs. 10.7 %, univariate analysis; p = 0.020), the effect was lost after adjusting for several factors associated with t-PA treatment [odds ratio for PSE after treatment with t-PA 1.3 (95 % CI 0.6–2.9), p = 0.489]. This study failed to identify treatment with t-PA as an independent risk factor for PSE.

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Authors and Affiliations

  1. Department of Neurology, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany

    Lena Keller, Carsten Hobohm, Samira Zeynalova, Joseph Classen & Petra Baum

  2. Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany

    Samira Zeynalova

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  1. Lena Keller
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Correspondence to Petra Baum.

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Keller, L., Hobohm, C., Zeynalova, S. et al. Does treatment with t-PA increase the risk of developing epilepsy after stroke?. J Neurol 262, 2364–2372 (2015). https://doi.org/10.1007/s00415-015-7850-0

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