Frequency of Abnormal Electroencephalography in Cases with Ischemic Stroke: Abnormal Electroencephalography in Ischemic Stroke

Ammar Yasir; Qudsum Yousaf; Madiha Malik; Mamoona Tanwir Rana; Muhammad Imran; Rashid Imran

doi:10.54393/pjhs.v5i11.2380

Authors

Ammar Yasir Department of Neurology, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Pakistan
Qudsum Yousaf Department of Neurology, Central Park Teaching Hospital, Lahore, Pakistan
Madiha Malik Department of Neurology, Rashid Latif Khan University Medical College, Hameed Latif Teaching Hospital, Lahore, Pakistan
Mamoona Tanwir Rana Department of Neurology, Akhtar Saeed Medical and Dental College, Lahore, Pakistan
Muhammad Imran Department of Neurology, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Pakistan
Rashid Imran Department of Neurology, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i11.2380

Keywords:

Ischemic Stroke, Electroencephalography, Acute Stroke Outcomes, Neurological Biomarkers

Abstract

Stroke was a common global condition, with low-income countries bearing the highest burden. It leads to reduced cerebral blood flow, limiting oxygen and glucose, and causing cerebral infarction. Electroencephalography has been used as a biomarker to predict outcomes in ischemic stroke during its acute and subacute phases. Objective: To determine the frequency of abnormal EEG in cases with ischemic stroke. Methods: After obtaining approval from the CPSP research evaluation unit, this cross-sectional study was conducted at the Department of Neurology, Punjab Institute of Neurosciences, Lahore, from January 2019 to June 2019 on 96 ischemic stroke patients. Written informed consent was taken from patients/attendants, and demographic details were noted. Using a CT scan, all cases were diagnosed as ischemic stroke. The EEG was done in all cases within 24 hours of admission. All data were entered and analyzed using SPSS version 26.0. Results: In the current study, 57.3% of patients with ischemic stroke were found to have abnormal EEG. Data stratification was found to be significant concerning gender and duration of stroke, p- value = 0.01 and 0.000, respectively. However, abnormal EEG frequency was noted more among 45-60-year-old male patients of normal weight and those who presented within 1-2 days of stroke. Conclusions: According to current study findings, more than half of the ischemic stroke cohort was found to have abnormal EEG. The high frequency of aberrant EEG results highlights the importance of EEG as a useful diagnostic tool when evaluating individuals who have had acute ischemic stroke.

References

Saini V, Guada L, Yavagal DR. Global epidemiology of stroke and access to acute ischemic stroke interventions. Neurology. 2021 Nov; 97(202): S6-16. doi: 10.1212/WNL.0000000000012781.

Kim J, Thayabaranathan T, Donnan GA, Howard G, Howard VJ, Rothwell PM et al. Global stroke statistics 2019. International Journal of Stroke. 2020 Oct; 15(8): 819-38. doi: 10.1177/1747493020909545.

Jurcau A and Simion A. Neuroinflammation in cerebral ischemia and ischemia/reperfusion injuries: from pathophysiology to therapeutic strategies. International Journal of Molecular Sciences. 2021 Dec; 23(1): 14. doi: 10.3390/ijms23010014.

Jadhav AP, Desai SM, Liebeskind DS, Wechsler LR. Neuroimaging of acute stroke. Neurologic Clinics. 2020 Feb; 38(1): 185-99. doi: 10.1016/j.ncl.2019.09.004.

Snyder DB. EEG characterization of sensorimotor networks: Implications in stroke (Doctoral dissertation, Marquette University). 2020 May.

Maura RM, Rueda Parra S, Stevens RE, Weeks DL, Wolbrecht ET, Perry JC. Literature review of stroke assessment for upper-extremity physical function via EEG, EMG, kinematic, and kinetic measurements and their reliability. Journal of NeuroEngineering and Rehabilitation. 2023 Feb; 20(1): 21. doi: 10.1186/s12984-023-01142-7.

Erani F, Zolotova N, Vanderschelden B, Khoshab N, Sarian H, Nazarzai L et al. Electroencephalography might improve diagnosis of acute stroke and large vessel occlusion. Stroke. 2020 Nov; 51(11): 3361-5. doi: 10.1161/STROKEAHA.120.030150.

Doerrfuss JI, Kilic T, Ahmadi M, Holtkamp M, Weber JE. Quantitative and qualitative EEG as a prediction tool for outcome and complications in acute stroke patients. Clinical EEG and Neuroscience. 2020 Mar; 51(2): 121-9. doi: 10.1177/1550059419875916.

Yoo HJ, Ham J, Duc NT, Lee B. Quantification of stroke lesion volume using epidural EEG in a cerebral ischaemic rat model. Scientific Reports. 2021 Jan; 11(1): 2308. doi: 10.1038/s41598-021-81912-2.

Geetha R and Priya E. Index for Assessment of EEG Signal in Ischemic Stroke Patients. InInternational Conference on Futuristic Communication and Network Technologies 2020 Nov: 825-834. doi: 10.1007/978-981-16-4625-6_82.

van Stigt MN, Groenendijk EA, van Meenen LC, van de Munckhof AA, Theunissen M, Franschman G et al. Prehospital detection of large vessel occlusion stroke with EEG: results of the ELECTRA-STROKE study. Neurology. 2023 Dec; 101(24): e2522-32. doi: 10.1212/WNL.0000000000207831.

Sutcliffe L, Lumley H, Shaw L, Francis R, Price CI. Surface electroencephalography (EEG) during the acute phase of stroke to assist with diagnosis and prediction of prognosis: a scoping review. BioMed Central Emergency Medicine. 2022 Feb; 22(1): 29. doi: 10.1186/s12873-022-00585-w.

Jia-lei YA, Guo-dong FE, Yin WU, Peng HE, Lang JI, Juan YA et al. Clinical and EEG features of ischemic stroke patients with abnormal discharges. Chinese Journal of Contemporary Neurology & Neurosurgery. 2016; 16(5): 285. doi: 10.3969/j.issn.1672-6731.2016.05.008.

Bukhari S, Yaghi S, Bashir Z. Stroke in Young Adults. Journal of Clinical Medicine. 2023 Jul; 12(15): 4999. doi: 10.3390/jcm12154999.

Gajurel BP, Karn R, Rajbhandari R, Ojha R. Patient Age and Outcome in Ischemic Stroke. Journal of Nobel Medical College. 2022 Dec; 11(2): 3-7. doi: 10.3126/jonmc.v11i2.50379.

Ohya Y, Matsuo R, Sato N, Irie F, Wakisaka Y, Ago T et al. Modification of the effects of age on clinical outcomes through management of lifestyle-related factors in patients with acute ischemic stroke. Journal of the Neurological Sciences. 2023 Mar; 446: 120589. doi: 10.1016/j.jns.2023.120589.

Ryu WS, Chung J, Schellingerhout D, Jeong SW, Kim HR, Park JE et al. Biological mechanism of sex difference in stroke manifestation and outcomes. Neurology. 2023 Jun; 100(24): e2490-503. doi: 10.1212/WNL.0000000000207346.

Dicpinigaitis AJ, Palumbo KE, Gandhi CD, Cooper JB, Hanft S, Kamal H et al. Association of elevated body mass index with functional outcome and mortality following acute ischemic stroke: the obesity paradox revisited. Cerebrovascular Diseases. 2022 Aug; 51(5): 565-9. doi: 10.1159/000521513.

Aoki J and Kimura K. The Body Mass Index as a Determinant of Acute Ischemic Location in Mild Non-cardioembolic Stroke Patients. Internal Medicine. 2024: 2926-3. doi: 10.2169/internalmedicine.2926-23.

Ag Lamat MS, Abd Rahman MS, Wan Zaidi WA, Yahya WN, Khoo CS, Hod R et al. Qualitative electroencephalogram and its predictors in the diagnosis of stroke. Frontiers in Neurology. 2023 Jun; 14: 1118903. doi: 10.3389/fneur.2023.1118903.

Sallam K, Kasem SM, El-Azab MH, Ahmed FB. Role of Electroencephalogram (EEG) AS Predictor to Post Stroke Seizures. Benha Medical Journal. 2023 Sep; 40(2): 359-67. doi: 10.21608/bmfj.2022.168342.1685.

Wijaya SK, Badri C, Misbach J, Soemardi TP, Sutanno V. Electroencephalography (EEG) for detecting acute ischemic stroke. In2015 4th International Conference on Instrumentation, Communications, Information Technology, and Biomedical Engineering (ICICI-BME). 2015 Nov: 42-48. doi: 10.1109/ICICI-BME.2015.7401312.

Dhakar MB, Sheikh Z, Kumari P, Lawson EC, Jeanneret V, Desai D et al. Epileptiform abnormalities in acute ischemic stroke: impact on clinical management and outcomes. Journal of Clinical Neurophysiology. 2022 Sep; 39(6): 446-52. doi: 10.1097/WNP.0000000000000801.

Rogers J, Middleton S, Wilson PH, Johnstone SJ. Predicting functional outcomes after stroke: an observational study of acute single-channel EEG. Topics in Stroke Rehabilitation. 2020 Apr; 27(3): 161-72. doi: 10.1080/10749357.2019.1673576.