{"id":5774,"date":"2019-07-10T00:00:00","date_gmt":"2019-07-10T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/the-risk-of-new-onset-epilepsy-and-refractory-epilepsy-in-older-adult-stroke-survivors\/"},"modified":"2023-06-14T19:23:56","modified_gmt":"2023-06-14T23:23:56","slug":"the-risk-of-new-onset-epilepsy-and-refractory-epilepsy-in-older-adult-stroke-survivors","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-risk-of-new-onset-epilepsy-and-refractory-epilepsy-in-older-adult-stroke-survivors\/","title":{"rendered":"The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors"},"content":{"rendered":"<p><strong>Objective <\/strong>&#x2014; Our study objectives were to identify factors associated with new-onset epilepsy and refractory epilepsy among older adult stroke survivors and to evaluate the receipt of diagnostic care and mortality for participants who developed epilepsy.<\/p>\n<p><strong>Methods <\/strong>&#x2014; We conducted a population-based, retrospective cohort study using linked, administrative healthcare databases. The Ontario Stroke Registry was used to identify patients 67 years and older who were hospitalized for a stroke at a designated stroke center in Ontario, Canada, between April 1, 2003, and March 31, 2009, and were previously free of epilepsy. Multivariable Fine&#x2013;Gray hazard models were used to examine risk factors of epilepsy and refractory epilepsy, accounting for the competing risk of death.<\/p>\n<p><strong>Results <\/strong>&#x2014; Among 19,138 older adults hospitalized for a stroke, 210 (1.1%) developed epilepsy and 27 (12.9%) became refractory to antiepileptic drugs. Within 1 year of epilepsy diagnosis, 24 (11.4%) patients were assessed with EEG and 19 (9.0%) with MRI. In multivariable analysis, younger age and thrombolysis receipt significantly increased epilepsy risk. Lesser stroke severity and anticoagulant medication receipt also significantly increased epilepsy risk; however, these effects decreased over time. Younger age and female sex were the only risk factors of refractory epilepsy. In the 5 years following epilepsy diagnosis, 97 (46.2%) participants died of any cause.<\/p>\n<p><strong>Conclusions <\/strong>&#x2014; Older adult stroke survivors are less likely to develop epilepsy and pharmacologically refractory epilepsy. An estimated 86.6% of deaths among older adult stroke survivors with new-onset epilepsy are attributed to causes other than stroke or epilepsy.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objective &#x2014; Our study objectives were to identify factors associated with new-onset epilepsy and refractory epilepsy among older adult stroke survivors and to evaluate the receipt of diagnostic care and mortality for participants who developed epilepsy. Methods &#x2014; We conducted a population-based, retrospective cohort study using linked, administrative healthcare databases. The Ontario Stroke Registry was [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-5774","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Burneo JG, Antaya TC, Allen BN, Belisle A, Shariff SZ, Saposnik G. <em>Neurology<\/em>. 2019; 93(6):e568-77. Epub 2019 Jul 10.","source_url":"http:\/\/doi.org\/10.1212\/WNL.0000000000007895","ices_scientist":[1169,1359],"site":[6739],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"FCFCB677-CAE0-4ACF-83DC-1AA096899FF2","sitecore_item_name":"The-risk-of-new-onset-epilepsy-and-refractory-epilepsy-in-older-adult-stroke-survivors","sitecore_field_values":"{\n  \"Title\": \"The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors\",\n  \"Short title\": \"The risk of new-onset epilepsy and\",\n  \"Summary\": \"The study objectives were to identify factors associated with new-onset epilepsy and refractory epilepsy among older adult stroke survivors and evaluate the receipt of diagnostic care and mortality.\",\n  \"Citation\": \"<p>Burneo JG, Antaya TC, Allen BN, Belisle A, Shariff SZ, Saposnik G. <em>Neurology<\/em>. 2019; 93(6):e568-77. Epub 2019 Jul 10. DOI: <a href=\"http:\/\/doi.org\/10.1212\/WNL.0000000000007895\" title=\"opens external link\">https:\/\/doi.org\/10.1212\/WNL.0000000000007895<\/a>.<\/p>\",\n  \"Abstract\": \"<p><strong>Objective <\/strong>&mdash; Our study objectives were to identify factors associated with new-onset epilepsy and refractory epilepsy among older adult stroke survivors and to evaluate the receipt of diagnostic care and mortality for participants who developed epilepsy.<\/p>n<p><strong>Methods <\/strong>&mdash; We conducted a population-based, retrospective cohort study using linked, administrative healthcare databases. The Ontario Stroke Registry was used to identify patients 67 years and older who were hospitalized for a stroke at a designated stroke center in Ontario, Canada, between April 1, 2003, and March 31, 2009, and were previously free of epilepsy. Multivariable Fine&ndash;Gray hazard models were used to examine risk factors of epilepsy and refractory epilepsy, accounting for the competing risk of death.<\/p>n<p><strong>Results <\/strong>&mdash; Among 19,138 older adults hospitalized for a stroke, 210 (1.1%) developed epilepsy and 27 (12.9%) became refractory to antiepileptic drugs. Within 1 year of epilepsy diagnosis, 24 (11.4%) patients were assessed with EEG and 19 (9.0%) with MRI. In multivariable analysis, younger age and thrombolysis receipt significantly increased epilepsy risk. Lesser stroke severity and anticoagulant medication receipt also significantly increased epilepsy risk; however, these effects decreased over time. Younger age and female sex were the only risk factors of refractory epilepsy. In the 5 years following epilepsy diagnosis, 97 (46.2%) participants died of any cause.<\/p>n<p><strong>Conclusions <\/strong>&mdash; Older adult stroke survivors are less likely to develop epilepsy and pharmacologically refractory epilepsy. An estimated 86.6% of deaths among older adult stroke survivors with new-onset epilepsy are attributed to causes other than stroke or epilepsy.<\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{3B4AF7E8-6835-410B-AEB8-360A79CA0ED8}\",\n  \"ICES Scientists\": \"{5800CF8C-9840-413D-B1BA-27422B322E2B}|{E8DA0CD3-1341-4EA5-846D-D3FCFCEB3137}\",\n  \"Posted Date\": \"20190710T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2019\/July\/The-risk-of-new-onset-epilepsy-and-refractory-epilepsy-in-older-adult-stroke-survivors"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors<\/title>\n<meta name=\"description\" content=\"Objective &#x2014; Our study objectives were to identify factors associated with new-onset epilepsy and refractory epilepsy among older adult stroke\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-risk-of-new-onset-epilepsy-and-refractory-epilepsy-in-older-adult-stroke-survivors\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors\" \/>\n<meta property=\"og:description\" content=\"Objective &#x2014; 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