{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:39:42Z","timestamp":1790044782111,"version":"4.0.1"},"reference-count":19,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T00:00:00Z","timestamp":1504569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recombinant tissue plasminogen activator is the only FDA-approved thrombolytic agent for acute stroke treatment. However, there are concerns that recombinant tissue plasminogen activator may increase the risk of seizures (including early and late seizures).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We performed a systematic review to assess the incidence of seizures and the association of recombinant tissue plasminogen activator with seizure occurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary of review<\/jats:title>\n                    <jats:p>We searched major databases for articles published between 1995 and February 2016. The pooled incidence of post-stroke seizure, early seizure, late seizure, and seizures sub-types was estimated overall and by status for recombinant tissue plasminogen activator treatment, and unadjusted odds ratio used to quantify the effects of recombinant tissue plasminogen activator on post-stroke seizure occurrence. In all, 4362 stroke participants were included with 49\u201363% being male and median age ranging from 68 to 71 years. A total of 792 received recombinant tissue plasminogen activator. The incidence of post-stroke seizure per 1000 participants (95% CI) was 95 (31\u2013196) overall, 113 (49\u2013202) in recombinant tissue plasminogen activator and 169 (6\u2013326) in non-recombinant tissue plasminogen activator-treated (all heterogeneity- p&lt;0.0001). Incidence of early seizure per 1000 (95% CI) was 35 (27\u201345) overall; 34 (22\u201350) among recombinant tissue plasminogen activator-treated patients, and 36 (25\u201348) among recombinant tissue plasminogen activator na\u00efve participants (all heterogeneity- p\u2009&gt;\u20090.826). The pool incidence rate per 1000 (95% CI) of late seizure was 84 (4\u2013263), 46 (2\u2013145), and 212 (184\u2013241), respectively, in the overall, the recombinant tissue plasminogen activator-treated group and non-recombinant tissue plasminogen activator-treated group (heterogeneity for overall and recombinant tissue plasminogen activator-treated group\u2009&lt;\u20090.0001, non-recombinant tissue plasminogen activator na\u00efve\u2009=\u20090.999). The pooled odds ratio for post-stroke seizure (recombinant tissue plasminogen activator vs. no recombinant tissue plasminogen activator) was 0.94 (95% CI: 0. 17\u20135.26, heterogeneity- p\u2009&lt;\u20090.0001). The pooled incidence per 1000 participants (95% CI) was 30 (0\u2013144), 17 (2\u201349), 16 (2\u201344), and 9 (0\u201350), respectively, for focal seizure without impairment of consciousness, focal seizure with impairment of consciousness, generalized convulsive seizure, and status epilepticus; all heterogeneity- p\u2009&lt;\u20090.0003. Accompanying pooled odds ratio (recombinant tissue plasminogen activator vs. no recombinant tissue plasminogen activator) based on one study was always in favor of non-significantly lower risk in recombinant tissue plasminogen activator-treated patients (all heterogeneity- p\u2009=\u20091). There were insufficient data to compute pooled odds ratio for early and late seizure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Seizures affect nearly 1 out of every 10 stroke patients with inconclusive suggestion that rates are similar in recombinant tissue plasminogen activator-treated and recombinant tissue plasminogen activator na\u00efve patients. Large prospective studies are needed to better understand the relationship between recombinant tissue plasminogen activator and post-stroke seizure occurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493017729239","type":"journal-article","created":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T08:33:32Z","timestamp":1504600412000},"page":"923-931","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Incidence of seizure in stroke patients treated with recombinant tissue plasminogen activator: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"12","author":[{"given":"Alain","family":"Lekoubou","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina, Charleston, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Jo\u00ebl","family":"Awoumou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Biomedical Sciences, Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Pascal","family":"Kengne","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cape Town, Cape Town, South Africa"},{"name":"South African Medical Research Council of South Africa, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,9,5]]},"reference":[{"key":"bibr1-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.11.1617"},{"key":"bibr2-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2009.08.007"},{"key":"bibr3-1747493017729239","doi-asserted-by":"crossref","unstructured":"Jungehulsing GJ, Heuschmann PU, Holtkamp M, Schwab S, Kolominsky-Rabas PL. Incidence and predictors of post-stroke epilepsy.\n                      Acta Neurol Scand\n                      2013; 127: 427\u2013430.","DOI":"10.1111\/ane.12070"},{"key":"bibr4-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.000220"},{"key":"bibr5-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2014.09.030"},{"key":"bibr6-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1172\/JCI0215961"},{"key":"bibr7-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0406454102"},{"key":"bibr8-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12550"},{"key":"bibr9-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"bibr10-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"bibr11-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6583-6"},{"key":"bibr12-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7850-0"},{"key":"bibr13-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9657-x"},{"key":"bibr14-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2010.01.004"},{"key":"bibr15-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182840c35"},{"key":"bibr16-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2015.10.002"},{"key":"bibr17-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1038\/377340a0"},{"key":"bibr18-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20101880"},{"key":"bibr19-1747493017729239","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.004000"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493017729239","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1747493017729239","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493017729239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:15:30Z","timestamp":1777706130000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1747493017729239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,5]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1177\/1747493017729239"],"URL":"https:\/\/doi.org\/10.1177\/1747493017729239","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,5]]}}}