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    Rights statement: This is the author’s version of a work that was accepted for publication in Epilepsy and Behavior. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Epilepsy and Behavior, 115, 2021 DOI: 10.1016/j.yebeh.2020.107634

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Late-onset epilepsy predicts stroke: Systematic review and meta-analysis

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Late-onset epilepsy predicts stroke: Systematic review and meta-analysis. / Wall, Jasmine; Knight, Jo; Emsley, Hedley C.A.
In: Epilepsy and Behavior, Vol. 115, 107634, 01.02.2021.

Research output: Contribution to Journal/MagazineReview articlepeer-review

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Wall J, Knight J, Emsley HCA. Late-onset epilepsy predicts stroke: Systematic review and meta-analysis. Epilepsy and Behavior. 2021 Feb 1;115:107634. Epub 2020 Dec 14. doi: 10.1016/j.yebeh.2020.107634

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@article{970c7b19bb9343049334ef1c65a5166d,
title = "Late-onset epilepsy predicts stroke: Systematic review and meta-analysis",
abstract = "Objective: Late-onset epilepsy (LOE) is closely associated with cerebrovascular disease, acting as both a marker of cerebrovascular disease (CVD) and occurring as a direct consequence. Despite this, our understanding of LOE as a cerebrovascular phenomenon is in its infancy. LOE also appears to be a harbinger of dementia. Methods: A systematic review was performed to identify publications relating to LOE and identified observational studies, clinical studies, and radiological studies. Results: A meta-analysis of observational studies demonstrated that patients presenting with LOE experience an increased risk of subsequent stroke (weighted OR 3.88 (95% CI 2.76–5.46)). The additional studies demonstrated clinical and radiological evidence to support the premise that LOE is likely to reflect underlying cerebrovascular disease. Significance: Cerebrovascular disease risk factors convey increased risk of LOE and LOE can precede stroke and dementia, acting as an early marker for cerebrovascular risk. This may represent a potential point for intervention. There are a number of suggested mechanisms relating LOE to stroke; however, there is limited understanding of the natural history of LOE. Current data support the need for prospective research in order to understand the natural history of LOE and modify disease, in order to reduce the apparent sequelae of stroke and dementia.",
keywords = "Alzheimer's dementia, Late-onset epilepsy, Late-onset seizure, Vascular dementia, White matter lesions",
author = "Jasmine Wall and Jo Knight and Emsley, {Hedley C.A.}",
note = "This is the author{\textquoteright}s version of a work that was accepted for publication in Epilepsy and Behavior. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Epilepsy and Behavior, 115, 2021 DOI: 10.1016/j.yebeh.2020.107634",
year = "2021",
month = feb,
day = "1",
doi = "10.1016/j.yebeh.2020.107634",
language = "English",
volume = "115",
journal = "Epilepsy and Behavior",
issn = "1525-5050",
publisher = "ELSEVIER ACADEMIC PRESS INC",

}

RIS

TY - JOUR

T1 - Late-onset epilepsy predicts stroke

T2 - Systematic review and meta-analysis

AU - Wall, Jasmine

AU - Knight, Jo

AU - Emsley, Hedley C.A.

N1 - This is the author’s version of a work that was accepted for publication in Epilepsy and Behavior. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Epilepsy and Behavior, 115, 2021 DOI: 10.1016/j.yebeh.2020.107634

PY - 2021/2/1

Y1 - 2021/2/1

N2 - Objective: Late-onset epilepsy (LOE) is closely associated with cerebrovascular disease, acting as both a marker of cerebrovascular disease (CVD) and occurring as a direct consequence. Despite this, our understanding of LOE as a cerebrovascular phenomenon is in its infancy. LOE also appears to be a harbinger of dementia. Methods: A systematic review was performed to identify publications relating to LOE and identified observational studies, clinical studies, and radiological studies. Results: A meta-analysis of observational studies demonstrated that patients presenting with LOE experience an increased risk of subsequent stroke (weighted OR 3.88 (95% CI 2.76–5.46)). The additional studies demonstrated clinical and radiological evidence to support the premise that LOE is likely to reflect underlying cerebrovascular disease. Significance: Cerebrovascular disease risk factors convey increased risk of LOE and LOE can precede stroke and dementia, acting as an early marker for cerebrovascular risk. This may represent a potential point for intervention. There are a number of suggested mechanisms relating LOE to stroke; however, there is limited understanding of the natural history of LOE. Current data support the need for prospective research in order to understand the natural history of LOE and modify disease, in order to reduce the apparent sequelae of stroke and dementia.

AB - Objective: Late-onset epilepsy (LOE) is closely associated with cerebrovascular disease, acting as both a marker of cerebrovascular disease (CVD) and occurring as a direct consequence. Despite this, our understanding of LOE as a cerebrovascular phenomenon is in its infancy. LOE also appears to be a harbinger of dementia. Methods: A systematic review was performed to identify publications relating to LOE and identified observational studies, clinical studies, and radiological studies. Results: A meta-analysis of observational studies demonstrated that patients presenting with LOE experience an increased risk of subsequent stroke (weighted OR 3.88 (95% CI 2.76–5.46)). The additional studies demonstrated clinical and radiological evidence to support the premise that LOE is likely to reflect underlying cerebrovascular disease. Significance: Cerebrovascular disease risk factors convey increased risk of LOE and LOE can precede stroke and dementia, acting as an early marker for cerebrovascular risk. This may represent a potential point for intervention. There are a number of suggested mechanisms relating LOE to stroke; however, there is limited understanding of the natural history of LOE. Current data support the need for prospective research in order to understand the natural history of LOE and modify disease, in order to reduce the apparent sequelae of stroke and dementia.

KW - Alzheimer's dementia

KW - Late-onset epilepsy

KW - Late-onset seizure

KW - Vascular dementia

KW - White matter lesions

U2 - 10.1016/j.yebeh.2020.107634

DO - 10.1016/j.yebeh.2020.107634

M3 - Review article

AN - SCOPUS:85097774053

VL - 115

JO - Epilepsy and Behavior

JF - Epilepsy and Behavior

SN - 1525-5050

M1 - 107634

ER -