A practical calculator that predicts the risk of epilepsy after a venous stroke is presented in a study by the University of Gothenburg and others. The aim is to improve care for those affected, who are predominantly young adults.
A blood clot in the cerebral venous system (cerebral venous thrombosis) is a rare but important cause of stroke. In Sweden, around 150 people are affected each year, usually affecting women between the ages of 20 and 50. One in three patients experience a seizure during the acute phase. Predicting who is at high or low risk of recurrent seizures is complicated.
In an international collaboration between fifteen centers on three continents, researchers from the Sahlgrenska Academy at the University of Gothenburg and the Sahlgrenska University Hospital have developed a practical calculator that quickly calculates the risk of developing epilepsy at the onset of the disease. The results of the multicenter study are now presented in JAMA Neurology, and the tool is available for free.
It is important to anticipate the consequences
The first author of the study is Erik Lindgren Bogdanoff, a researcher in the Section of Clinical Neurosciences, Sahlgrenska Academy at the University of Gothenburg and MD in Neurology at the Sahlgrenska University Hospital.
“The calculator predicts the risk of epilepsy based on factors that are already available in the clinical routine when the person is hospitalized, so no additional tests or investigations are needed,” he says and continues:
“For those affected by sinus thrombosis, it is very important to know what the sequelae are like. Previously, we have not been able to predict which patients have the highest risk of developing epilepsy after cerebral venous thrombosis.” With a high predicted risk of future seizures, preventive medication may be considered in consultation between physician and patient.
Erik Lindgren Bogdanoff emphasizes that although epilepsy could have a negative impact on quality of life, most people with epilepsy are able to continue living normally even with a diagnosis of epilepsy. However, without proper treatment, seizures can be so severe that they require hospitalization. It is hoped that the calculator can be used by doctors around the world to support treatment decisions or inform patients about risks and can be used in future studies on preventive drug therapy.
It can improve care for young people
The study is based on registry data from the International Cerebral Venous Thrombosis Consortium (ICVTC), and the results have since been confirmed in two additional independent registries: the US ACTION-CVT and the Israeli CVT Study. In total, data from more than 2,000 people have been analyzed.
The involvement of research participants, along with extensive international collaboration, has been a prerequisite for gathering sufficient data and conducting studies, even though it is a rare disease, that provide results that can be translated into clinical practice. Although the disease itself is relatively rare, it is important to improve care for sufferers. The results are a step towards more person-centred care for young people with stroke.”
Erik Lindgren Bogdanoff, Sahlgrenska Academy, University of Gothenburg
Source:
Journal Reference:
Lindgren, E., et al. (2024). Development and validation of a clinical score to predict epilepsy after cerebral venous thrombosis. JAMA Neurology. doi.org/10.1001/jamaneurol.2024.3481.
