Should Patients with Seizure at Stroke Onset Receive Thrombolysis?

An observational study shows no increase in brain hemorrhage with seizure at stroke onset.

In the original study that evaluated tissue plasminogen activator (alteplase) for acute ischemic stroke, patients were excluded if they had a seizure at stroke onset. This exclusion has led to ambiguity as to whether or not seizure at onset (SaO) is a contraindication for alteplase administration.

These authors conducted a review of patients with acute stroke who received thrombolytic treatment at nine centers in Europe. They assessed whether SaO was associated with any difference in symptomatic intracerebral hemorrhage (sICH), 3-month mortality, and 3-month functional outcome.

Among 10,074 patients treated with intravenous thrombolysis for ischemic stroke, SaO was identified in 1.5%. Patients with SaO were more likely to be women (54% vs. 45…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Should Patients with Seizure at Stroke Onset Receive Thrombolysis?

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Reviewing Author