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NEUROLOGY 2006;67:2048-2049
© 2006 American Academy of Neurology
Brief Communications

Seizures during stroke thrombolysis heralding dramatic neurologic recovery

L. H. Rodan, BSc, R. I. Aviv, MRCP, FRCR, D. J. Sahlas, MSc, MD, FRCPC, B. J. Murray, MD, FRCPC, J. P. Gladstone, MD, FRCPC and D. J. Gladstone, MD, FRCPC, PhD

From the North and East GTA Regional Stroke Centre, Division of Neurology (Department of Medicine), Division of Neuroradiology, and Neurosciences Program, Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, Ontario, Canada, and the Heart and Stroke Foundation Centre for Stroke Recovery.

Address correspondence and reprint requests to Dr. David J. Gladstone, Division of Neurology and Regional Stroke Centre, A442, Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5; e-mail: david.gladstone{at}sw.ca

Seizures during thrombolytic therapy for ischemic stroke have not previously been described as a favorable prognostic sign. We report three patients with severe stroke (NIH Stroke Scale [NIHSS] score 15 to 20) who experienced a seizure during tissue plasminogen activator (tPA) infusion. While initially raising alarm about possible hemorrhage, the seizures heralded dramatic recovery (an immediate 15-point NIHSS score improvement after tPA; NIHSS score 0 or 1 at 24 hours). We propose that the seizures during thrombolysis may indicate cortical reperfusion and/or hyperperfusion due to early recanalization of an acutely occluded intracranial artery.

Disclosure: The authors report no conflicts of interest.

Received October 27, 2005. Accepted in final form August 13, 2006.




This article has been cited by other articles:


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M. Seeck and S. Vulliemoz
SEIZURES DURING STROKE THROMBOLYSIS HERALDING DRAMATIC NEUROLOGIC RECOVERY
Neurology, July 24, 2007; 69(4): 409 - 410.
[Full Text] [PDF]

Correspondence:

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Seizures during stroke thrombolysis heralding dramatic neurologic recovery
Margitta Seeck, et al.
Neurology Online, 3 Apr 2007 [Full text]

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