epilepsy after brain infarction post-stroke epilepsy
Conditions
Interventions
None listed
Sponsors
Medisch Universitair Ziekenhuis Maastricht
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: - Patients suffering from stroke (and post-stroke epilepsy), including both brain infarction, cerebral hemorrhage and clinically significant hemorrhagic transformation of stroke (or a primary intracerebral hemorrhage) - Patients suffering from post-stroke epilepsy after cortical stroke defined as one or more unprovoked epileptic seizures occurring more than one week after the stroke, according to International League Against Epilepsy criteria. - Patients suffering from cortical stroke, with the onset of acute stroke symptoms more than 4 months prior to inclusion. - Age > 18 years
Exclusion criteria
Exclusion criteria: -onset of stroke (and epilepsy for post-stroke epilepsy patients) less than 4 months ago -In case of the PSE group: onset of epilepsy within a week or 2 years after the onset of stroke. -previous history of epilepsy -history of another cerebral disorder (neurodegenerative diseases, tumours) -inability to provide informed consent - any contraindication for MRI: metallic foreign body, pacemaker, claustrophobia, pregnancy, tattoos, permanent make-up. - known contrast allergy to gadolinium, insufficient kidney function (eGFR
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| - Stroke and post-stroke epilepsy outcome will be assessed using the NIHSS. - All patients and healthy controls will undergo cognitive testing: • To assess level of function Raven's Progressive Matrices is used. • To assess central processing speed the CVST will be used. • In addition the highest premorbid educational level will be determined. Laesional deficits (such as dysphasia) will be tested at inclusion. | — |
Primary
| Measure | Time frame |
|---|---|
| - BBB permeability as determined by DCE-MRI to assess the leakiness of the cerebral vasculature by dynamically measuring the rate of contrast agent transfer from blood into the interstitial space (leakage rate; units: mL / (min 100 g tissue)). We will compare BBB permeability in PSE patients with non-PSE patients and healthy controls. - Perfusion as determined by DSC MRI. With this method we obtain information about the CBF, the cerebral blood volume (CBV), and mean transit time (MTT). We will compare these in PSE patients with non-PSE patients and healthy controls. - Resting state functional MRI: connectivity measures, locally as well as whole brain network analysis (using graph theoretical measures) as well as DTI connectivity measures, locally (mean diffusivity/fractional anisotropy) and anatomical features (measured by standard T2, SWI and FLAIR sequences: gliosis, iron deposits microbleeds, dilated perivascular spaces, and cortical and subcortical ischemic lesions). | — |
Countries
Netherlands
Outcome results
None listed