Abstracts

Rationale: Late seizures are well known sequelae after stroke. Previous history of stroke and dementia is common etiology of epilepsy, however, the effect of cognitive impairment on late seizures has not been fully investigated. This study aimed to investigate the clinical significance of cognitive scores to predict the occurrence of poststroke late seizures.

Methods: We retrospectively investigated adult patients with acute cerebral infarction who were admitted to our department between January 1, 2019 and December 31, 2019 and followed-up for at least 11 months. We performed Japanese version of the Addenbrooke’s Cognitive Examination (ACE)-Ⅲ and the Montreal Cognitive Assessment (MoCA-J) within 1 month after stroke onset. Cognitive scores were compared between patients with and without late seizures during follow-up period. Late seizures are defined as seizures at least two weeks apart from stroke onset.

Results: 53 patients were enrolled. 8 patients were unable to evaluate because of severe consciousness disturbance. Of 45 patients (28 males, age 77.2 ± 8.5 years (mean ± SD)), 8 patients (4 males, age 82.1 ± 4.2 years) had late seizures. The scores of ACE-Ⅲ and MoCA-J were significantly lower in patients with late seizures than those without late seizures (27.5 ± 17.3 vs 59.1 ± 27.2, 7.6 ± 5.9 vs 15.4 ± 8.6, p< 0.05, t-test)(Fig.1). Receiver operating characteristic (ROC) analysis revealed that ACE-Ⅲ was more suitable than MoCA-J, and the most optimal cut-off values were ACE-Ⅲ ≦58.5 (sensitivity 1.00, specificity 0.62) or ≦45.0 (0.88, 0.73), and MoCA-J ≦18.0 (1.00, 0.43) or ≦11.0 (0.75, 0.70) to predict late seizures (Fig. 2, points A-D, respectively).

Conclusions: Cognitive scores, especially ACE-Ⅲ, are useful to predict late seizures in adult patients with cerebral infarction.

Funding: Please list any funding that was received in support of this abstract.: There are no companies, etc. in a relation of conflict of interest requiring disclosure in relation to the presentation.