Evidence map›Paper›PMID 40568812›Full record

ArticleAnnals of neurology2025

The Role of Electroencephalography in Predicting Post-Stroke Seizures and an Updated Prognostic Model (SeLECT-EEG).

Kai Michael Schubert, Vijaya Dasari, Ana Lúcia Oliveira, Chiara Tatillo, Gilles Naeije, Adam Strzelczyk, Giovanni Merlino, Mariarosaria Valente, Nicolas Gaspard, Vineet Punia and 3 more

Abstract readMulticenter Study
In one paragraph

Article in Annals of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kai Michael SchubertDepartment of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.ORCID 0000-0003-1438-7544
Vijaya DasariEpilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
Ana Lúcia OliveiraDepartment of Neurosciences and Mental Health (Neurology), Hospital de Santa Maria-ULSSM. Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.ORCID 0000-0003-4005-4591
Chiara TatilloDepartment of Neurology, Hôpital Universitaire de Bruxelles - Hôpital Erasme, Brussels, Belgium.
Gilles NaeijeDepartment of Neurology, Hôpital Universitaire de Bruxelles - Hôpital Erasme, Brussels, Belgium.
Adam StrzelczykEpilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany.ORCID 0000-0001-6288-9915
Giovanni MerlinoDepartment of Medicine, University of Udine and Clinical Neurology, Udine University Hospital, Udine, Italy.
Mariarosaria ValenteDepartment of Medicine, University of Udine and Clinical Neurology, Udine University Hospital, Udine, Italy.
Nicolas GaspardDepartment of Neurosciences and Mental Health (Neurology), Hospital de Santa Maria-ULSSM. Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Vineet Punia *Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0002-0552-6736
Marian Galovic *Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
Carla Bentes *Department of Neurosciences and Mental Health (Neurology), Hospital de Santa Maria-ULSSM. Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
SeLECT Collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSeizures negatively impact stroke outcomes, highlighting the need for reliable predictors of post-stroke epilepsy. Although acute symptomatic seizures are a known risk factor, most stroke survivors who develop epilepsy do not experience them. Early electroencephalography (EEG) findings may enhance risk prediction, particularly in patients without acute symptomatic seizures, aiding in patient management and counseling.

methodsWe conducted a multicenter cohort study using data from 1,105 stroke survivors (mean age 71 years, 54% male) with neuroimaging-confirmed ischemic stroke who underwent EEG within 7 days post-stroke. Electrographic biomarkers, including epileptiform activity and regional slowing, were analyzed for their association with post-stroke epilepsy using Cox proportional hazards regression and Fine-Gray subdistribution hazard models, adjusted for differences in EEG timing and patient characteristics.

resultsPost-stroke epilepsy developed in 119 patients (11%), whereas 233 (21%) had acute symptomatic seizures. The 5-year epilepsy risk was 42% (95% confidence interval [CI]: 30-49%) in patients with epileptiform activity versus 13% (95% CI: 9-16%) in those without. Regional slowing doubled the 5-year epilepsy risk (23%, 95% CI: 17-30% vs 11%, 95% CI: 7-16%). Epileptiform activity (subdistribution hazard ratio: 2.3, 95% CI: 1.5-3.4, p < 0.001) and regional slowing (subdistribution hazard ratio: 1.7, 95% CI: 1.1-2.7, p = 0.02) were independently associated with post-stroke epilepsy. A novel prognostic model, SeLECT-EEG (concordance statistic: 0.75, 95% CI: 0.71-0.80), outperformed the previous standard (SeLECT

interpretationElectrographic biomarkers improve post-stroke epilepsy prediction beyond clinical risk factors. The SeLECT-EEG model enhances early risk stratification, particularly in patients without acute symptomatic seizures, informing management strategies and patient counseling. ANN NEUROL 2025;98:814-825.

Indexed as

ElectroencephalographyEpilepsySeizuresStrokeAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRisk Factors

Identifiers

PMID40568812
PMCPMC12542305

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.