Short-term functional outcome of post-stroke seizure patients in Yaounde

Rita Arrey Ngonto Ndip-Agbor
Internal medecine, The University of Yaounde 1
July, 2017
 

Abstract

Introduction:
Stroke is a public health problem in sub Saharan African as African countries are undergoing an epidemiological transition driven by socio-demographic and lifestyle changes. As a cerebrovascular complication, this pathology is coupled with direct and indirect complications which worsens the morbidity and mortality. Amongst the neurological manifestations, seizures account for a significant proportion and hence aggravates this public health challenge. Insufficient data on post-stroke seizures and functional outcome are lacking in Cameroon. and could be accounted for by the difficulty in following up patients after discharge probably due to financial constraints in respecting the various stages in rehabilitation and the small number of health professionals specialized in re-education.
Objectives
In this study we sought to determine the short-term functional outcome of seizures and specifically, describe the clinical profile of a sample of stroke patients with seizures and stroke patients without seizures as well as compare the short-term functional outcome of stroke patients in both groups.
Methodology
We carried out a 1:3 Ritacase-control study. Cases were considered as post-stroke seizure patients and controls as stroke patients. Cases were matched with controls for age and sex. Subjects were clerked and examined with the functional outcome evaluated after three months after discharge using the modified Rankin scale with scores≤2 considered favourable and values >2 considered unfavourable and stroke severity evaluated using the NIHSS score. The data was analysed with Epic info version 7.0 and SPSS version 20.0. Cut off statistical significance was set at 0.05.
Results
Demographic, clinical and short-term functional outcome data was collected for 7 post-stroke seizure patients and 21 stroke patients. The mean age in the case and control group was 57.5(42.5 – 64.0). The most identified risk factor was hypertension which was 42.9% in cases and 90.5% in controls secondly followed by Diabetes which was 14.3% in cases and 19% in controls. 85% of post-stroke seizures were early onset and 15% of late-onset of which 85.7% were generalized and 14.3% were focal. Stroke severity in cases were as follows, 28%(2/7) had no symptom,14.8%(1/7) had minor symptoms,42.9%(3/7) had moderate symptoms and 14.3%(1/7) had severe symptoms. MRs >2 was considered unfavorable of which 57.1%(4/7) were cases and 42.9%(3/7) had favourable short-term functional outcome with mRs ≤2. For controls, 14%(1/21) had minor symptoms of stroke ,76%(16/21) had moderate symptoms and 19%(4/21) had severe symptoms. Forty seven percent (10/21) of controls had favourable short-term functional outcome while 52.9%(11/21) had unfavorable short-term functional outcome.
Both functional outcome and stroke severity in both groups were statistically non-significant.
Conclusion
Our results show that post-stroke seizures does not modify the short-term functional outcome of stroke patients. These results come to reinforce other studies carried out showing similar findings.
We recommend that this study should be done in a larger population and that a cohort study should be done.


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