{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:55:21Z","timestamp":1788857721568,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014996","name":"Health Commission of Zhejiang Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015807","name":"Hangzhou Municipal Health and Family Planning Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>\n                    <jats:bold>Background and Purpose:<\/jats:bold>\n                    Convulsive seizures related to posterior circulation stroke are considered rare. However, some patients with acute basilar artery occlusion (BAO) can present with convulsive movements. Misdiagnosed as seizures may delay the reperfusion therapy for acute BAO. In this study, we have summarized the clinical features and possible mechanisms of BAO presenting with convulsive movements.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We performed an Institutional Review Board-approved institutional database query from 2015 to 2020 and a literature search of the online database PubMed. Clinical data were collected and analyzed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    In total, 14 patients with acute BAO presented with convulsions. There were 10 men and 4 women, with a mean age of 53 (range, 23\u201377) years. All of these patients had different degrees of impaired consciousness (100.0%, 14\/14). Convulsive movements were the initial symptoms in 78.6% (11\/14) of patients. Further, 64.3% (9\/14) of patients presented with paralysis or cranial nerve abnormalities, and 85.7% (12\/14) of patients were treated with reperfusion therapy (thrombolysis, 35.7% [5\/14]; endovascular thrombectomy, 64.3% [9\/14]). The BAO etiology and mechanism were related to embolism, vessel dissections, and severe stenosis of the right vertebral artery in 57.1% (8\/14), 21.4% (3\/14), and 7.1% (1\/14) of patients, respectively; they were undefined in 14.3% (2\/14) of patients. Moreover, 42.9% (6\/14) of patients had a 90-day modified Rankin Scale score of 0\u20132, and the mortality rate was 21.4% (3\/14).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Acute BAO, especially that related to embolism or vessel dissection, may present with convulsive movements. Acute BAO is a devastating, but treatable disease if diagnosed in time. Considering the possibility of BAO is important when dealing with patients presenting with acute-onset convulsive movements. Prompt diagnosis and reperfusion therapy may help achieve a better prognosis.\n                  <\/jats:p>","DOI":"10.3389\/fneur.2021.803618","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T02:33:41Z","timestamp":1641522821000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Acute Basilar Artery Occlusion Presenting With Convulsive Movements: A Systematic Review"],"prefix":"10.3389","volume":"12","author":[{"given":"Dan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yigang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggang","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyue","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2324709620940497","DOI":"10.1177\/2324709620940497","article-title":"Stroke-onset seizures during midbrain infarction in a patient with top of the basilar syndrome","volume":"8","author":"Mader","year":"2020","journal-title":"J Investig Med High Impact Case Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s11910-019-0957-4","article-title":"and Forgacs PB. Incidence, implications, and management of seizures following ischemic and hemorrhagic stroke","volume":"19","author":"Doria","year":"2019","journal-title":"Curr Neurol Neurosci Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.03.012","article-title":"and Van Maele G. Seizures and epilepsy in patients with a posterior circulation infarct","volume":"211","author":"De","year":"2012","journal-title":"J Stroke Cerebrovasc Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1001\/archneur.58.4.654","article-title":"and Caplan LR. Convulsive-like movements in brainstem stroke","volume":"58","author":"Saposnik","year":"2001","journal-title":"Arch Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.2169\/internalmedicine.50.4801","article-title":"Top of the basilar syndrome in a young adult initially presenting with a convulsive seizure","volume":"50","author":"Matsuo","year":"2011","journal-title":"Intern Med."},{"key":"B6","first-page":"314","article-title":"Basilar artery occlusion presenting as a tonic-clonic seizure","volume":"13","author":"Gadoth","year":"2011","journal-title":"Isr Med Assoc J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1136\/practneurol-2013-000585","article-title":"Spontaneous limb movements and posturing secondary to acute basilar artery occlusion: a potentially devastating seizure mimic","volume":"14","author":"Wilson","year":"2014","journal-title":"Pract Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1001\/jamaneurol.2016.3449","article-title":"Top of the basilar syndrome presenting with convulsions","volume":"74","author":"Conte","year":"2017","journal-title":"JAMA Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.wneu.2018.05.227","article-title":"Basilar artery occlusion with Seizures as a presenting symptom: three cases treated using mechanical thrombectomy","volume":"117","author":"Otsuji","year":"2018","journal-title":"World Neurosurg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e53","DOI":"10.1016\/j.jemermed.2020.04.038","article-title":"Top of basilar syndrome presenting with hyperekplexia initially diagnosed as a convulsive status epilepticus","volume":"59","author":"Bourmaf","year":"2020","journal-title":"J Emerg Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.mayocpiqo.2020.12.002","article-title":"Refractory left focal motor status epilepticus as initial clinical presentation of acute basilar artery thrombosis","volume":"5","author":"Bhatt","year":"2021","journal-title":"Mayo Clin Proc Innov Qual Outcomes."},{"key":"B12","first-page":"671","article-title":"Ischemic stroke due to acute basilar artery occlusion: proportion and outcomes","volume":"12","author":"Israeli-korn","year":"2010","journal-title":"Isr Med Assoc J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1136\/jnnp.2004.049924","article-title":"Outcome in patients with basilar artery occlusion treated conventionally","volume":"76","author":"Schonewille","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B14","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1159\/000479939","article-title":"Mechanical thrombectomy for acute basilar artery occlusion in early therapeutic time window","volume":"44","author":"Uno","year":"2017","journal-title":"Cerebrovasc Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.jocn.2020.12.034","article-title":"Endovascular treatment of acute basilar artery occlusion: Outcomes, influencing factors and imaging characteristics from the Tama-REgistry of acute thrombectomy (TREAT) study","volume":"86","author":"Kaneko","year":"2021","journal-title":"J Clin Neurosci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1016\/S1474-4422(11)70229-0","article-title":"Basilar artery occlusion","volume":"10","author":"Mattle","year":"2011","journal-title":"Lancet Neurol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1769","DOI":"10.1161\/01.STR.0000130989.17100.96","article-title":"Seizures and epilepsy after ischemic stroke","volume":"35","author":"Camilo","year":"2004","journal-title":"Stroke."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.3171\/2017.7.JNS171043","article-title":"Mechanical thrombectomy in basilar artery occlusion: influence of reperfusion on clinical outcome and impact of the first-line strategy (ADAPT vs stent retriever)","volume":"129","author":"Gory","year":"2018","journal-title":"J Neurosurg."},{"key":"B19","first-page":"2425","article-title":"Role of the brain-stem reticular formation in tonic-clonic seizures: lesion and pharmacological studies","volume":"44","author":"Browning","year":"1985","journal-title":"Fed Proc"},{"key":"B20","first-page":"513","article-title":"Epileptic automatism and the centrencephalic integrating system","volume":"30","author":"Penfield","year":"1952","journal-title":"Res Publ Assoc Res Nerv Ment Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/0306-4522(93)90160-H","article-title":"Mechanisms of supraspinal correction of locomotor activity generator","volume":"52","author":"Degtyarenko","year":"1993","journal-title":"Neuroscience."},{"key":"B22","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/BF00313183","article-title":"Involuntary motor phenomena in the locked-in syndrome","volume":"223","author":"Bauer","year":"1980","journal-title":"J Neurol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1152\/jn.1958.21.5.430","article-title":"Electro-clinical features of convulsions induced by stimulation of brain stem","volume":"21","author":"Kreindler","year":"1958","journal-title":"J Neurophysiol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1159\/000334754","article-title":"Convulsive movements in bilateral paramedian thalamic and midbrain infarction","volume":"3","author":"Yamashiro","year":"2011","journal-title":"Case Rep Neurol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1186\/s12883-019-1551-8","article-title":"Endovascular treatment for acute basilar artery occlusion: a single center retrospective observational study","volume":"19","author":"Sun","year":"2019","journal-title":"BMC Neurol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1001\/jamaneurol.2020.0156","article-title":"Assessment of endovascular treatment for acute basilar artery occlusion via a nationwide prospective registry","volume":"77","author":"Zi","year":"2020","journal-title":"JAMA Neurol."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.803618\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T02:33:47Z","timestamp":1641522827000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.803618\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":26,"alternative-id":["10.3389\/fneur.2021.803618"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.803618","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,7]]},"article-number":"803618"}}