Influence of Screening Day on Select Score for Risk Assessment of Post-stroke Epilepsy
Abstract number :
3.346
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2024
Submission ID :
147
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Denise Birk, MD – University Hospital of Munich (LMU)
Jakob Lichtenberger, MD – University Hospital of Munich (LMU)
Jan Remi, MD – University Hospital of Munich (LMU)
Rationale: The SeLECT score was established in 2018 in order to evaluate the risk of developing post-stroke epilepsy. It is comprised of five variables: Severity of stroke (up to 2 points), large-artery atherosclerotic etiology (1 point), early seizures (3 points), cortical involvement (2 points) and territory of the middle cerebral artery (1 point). Originally, patients were screened within 48 hours after stroke to calculate the five-year-risk of late seizures. We aimed to evaluate the influence of a later screening point in time on the value of the SeLECT score.
Methods: In our center, stroke patients were screened with the SeLECT score between 2019 and 2022 as part of a multicenter trial (BIA-2093-213), the median screening day being day 2 after stroke. We retrospectively screened 211 patients a second time at their day of discharge, which, in median, fell on day 7 after admission. The values of the SeLECT score were compared and reasons for discrepancies were analysed.
Results: Of the 211 patients 9 had to be excluded, because they suffered from stroke mimics. For the 202 remaining patients the SeLECT score stayed equal in 61% of the cases, 20% showed a higher score in the second screening and 19% percent a lower one. Reasons for both an increase and decrease in the score were mainly the results of extended diagnostic tests, especially with respect to large-artery atherosclerotic etiology being, in either case, the main reason for the score-deviation between screening points. Furthermore, additional imaging after the initial CT scan partly revealed cortical involvement or territory of the middle cerebral artery. In one case, the occurrence of an early seizure after the primary screening led to an increase in the SeLECT score.
Conclusions: This study shows that the timing of screening stroke patients with the SeLECT score has profound influence on the point value. Screening patients prior to discharge or at day 7 of hospitalization could improve the accuracy of the SeLECT score compared to a screening shortly after admission to the stroke unit. This has to be valued against the value of early screening to be able to initiate early treatment.
Funding: No funding.
Clinical Epilepsy