The Frequency, Predictors and Health Impact of Post-Stroke Extrapyramidal Disorders (Clinical and Epidemiological Study)

Abstract

Background: Post-stroke extrapyramidal disorders (PSEDs) significantly impair functional outcomes but remain poorly characterized in  stroke populations. Understanding the frequency, risk factors, and health impacts of PSEDs is essential for improving stroke  management and rehabilitation strategies.

Objective: To assess the incidence, risk variables, and impact of post-stroke extrapyramidal illnesses on functional outcome in a hospital-based population.

Patients and Methods: This nested case-control study was conducted from October 2017 to September 2020. Among 1,971 acute  cerebrovascular stroke patients screened, 167 met the inclusion criteria, divided into 69 cases with PSEDs and 98 controls without.  Extensive neurological exams, brain imaging, and the Abnormal Involuntary Movement Scale (AIMS) were utilized to diagnose PSEDs.  Risk factors were analyzed using logistic regression in IBM SPSS 21.0.

Results: PSEDs developed in 3.5% of the stroke patients. Significant  risk factors included older age (OR = 1.067, 95% CI: 1.037–1.097), diabetes mellitus (OR = 4.476, 95% CI: 1.987–8.083), and deep lesion site  (OR = 3.477, 95% CI: 1.683–7.184). Patients with PSEDs were more likely to exhibit dementia (47.8% vs. 19.4%, P = 0.006) and had worse functional outcomes as measured by the Barthel Index (82.6% with poor outcomes vs. 61.2% in controls, P = 0.003).

Conclusion: Post- stroke extrapyramidal disorders are associated with significant functional impairment and are more likely in patients with specific risk  factors such as advanced age, diabetes, and deep brain lesions. Early identification and tailored management of these risk factors may  improve outcomes in stroke patients at risk of PSEDs.