Seizures in patients with symptomatic cervical artery occlusion by dissection and by atherosclerosis

The outcome of patients with occlusion by cervical dissection (OCD) is considered to be better than of those with atherosclerotic occlusion (ATO) of cervical arteries. The present observational retrospective study investigates whether there are also differences in the occurrence of seizures between OCD and ATO patients. The characteristics and the occurrence of seizures in 199 consecutive patients with a stroke due to a cervical artery occlusion are determined. Forty patients with OCD and 159 with ATO are compared. Occlusion by cervical dissection patients are significantly younger and have less vascular risk factors than those with ATO. Stroke type, vascular territory, NIHS score and outcome are similar. Three (7.5%) OCD and 29 (18.2%) ATO patients developed seizures. However, this difference is not statistically significant (P = 0.146). On multiple logistic regression analysis, ageing and arterial hypertension are independent variables. This study suggests a lower incidence of seizures in patients with OCD compared to those with ATO, although not statistically proven, due to the small sample size. Age and arterial hypertension can explain this difference.