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February 1991

Seizures Following Carotid Endarterectomy-Reply

Author Affiliations

Department of Neurology University of Rochester Medical Center 601 Elmwood Ave, Box 673 Rochester, NY 14642

Arch Neurol. 1991;48(2):131. doi:10.1001/archneur.1991.00530140019010

In Reply.  —In his letter, Sinoff asserts that seizures following carotid endarterectomy (CEA) occurred less frequently than expected in our study population. To substantiate his assertion he provides several references for the incidence of seizures following stroke. We suggest that not all patients having a CEA also have a stroke. A generous estimate of the incidence of stroke following CEA at our institution is 5%, based on prior reports from our institution and others.1,2 Using this estimate for the incidence of stroke in patients with CEA, and using the incidence figures for seizure following stroke provided by Sinoff, 2.25 cases of seizures due to stroke following CEA would have been expected in our study population. This falls outside the 95% confidence interval for the observed number of eight cases of seizures following CEA, based on the binomial distribution. Therefore, we actually reported that seizures following CEA occurred more frequently

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