Epileptic seizure after stroke in Chinese patients

Abstract

This was a hospital-based cohort study aiming at determining the occurrence rate of post-stroke seizures and the associated risk factors. From 27 July 1996 to 16 June 1998, the first 1000 consecutive patients in the acute stroke registry were retrospectively reviewed for one year after acute stroke to identify seizure occurrence. The demographic data, seizure onset time, seizure type, drug treatment, response to medication, electroencephalogram findings and cranial computed tomogram findings were collected. Thirty-four patients (3.4%) developed seizure within one year after acute stroke. Univariate analysis revealed that male, age greater than 65 years, total anterior circulation infarction, partial anterior circulation infarction, cortical location and large lesion were significantly associated with post-stroke seizure while multivariate analysis showed that only male (adjusted OR 3.21, p<0.01) and cortical location (adjusted OR 3.83, p<0.05) were significant independent risk factors. Fifty-six percent of early seizures were partial type whereas 72% of late seizures were generalized tonic-clonic type of undetermined onset. Seizures occurred in 3.4% of patients within one year after the onset of stroke. This percentage of seizure occurrence and associated risk factors were similar to other studies. However, intracerebral and subarachnoid haemorrhage were not shown to be risk factors in our study.

Predictors and outcome of seizures after spontaneous intracerebral hemorrhage

“…Although the frequency of seizures after spontaneous ICH is estimated at 2.8-18.7%, 1,3,4,6,9,14,15,19 much of these data were based on retrospective studies with variable follow-up. In our study, seizures occurred in 20 (8.2%) of the 243 patients who had spontaneous ICH, including acute symptomatic seizures in 9 patients (3.7%) and unprovoked seizures in 11 (4.5%).…”

“…Epilepsy in patients who have had spontaneous ICH may have delayed manifestation, but most occur within 2 years. 1 Epileptic seizures after spontaneous ICH have been reported in 2.8-18.7% of patients in various studies, 1,3,4,6,9,14,15,19 and seizures only in patients with strokes and cerebral hemisphere lesions. 4,18 The indications for and duration of seizure treatment required after spontaneous ICH remain controversial, although Passero et al 18 recently demonstrated that the risk of early seizures was reduced with prophylactic AED therapy in patients with lobar ICH.…”

“…5 The authors of most large studies of seizures after stroke have focused either on ischemic and hemorrhagic stroke together or hemorrhagic stroke exclusively. 1,[4][5][6] However, few researchers have examined the clinical features of seizures in patients who have had spontaneous ICH. 3,9,14,15,19 The majority of previous studies have included relatively few patients, 9,14 less strict selection, and included seizures that occurred only in the acute phase of spontaneous ICH or during a shorter follow-up period.…”

Clinical Features of Postroke Epilepsy and Relationship with Prognosis

“…[5,6] İnme sonrası nöbet gelişmesi için risk faktörleri olarak bazı çalışmalarda hemorajik inme, kardiyo-embolik inme, inme şiddeti, kortikal yerleşim, birden fazla lobun tutulumu gibi faktörler bildirilmektedir. [7] Bu çalışmada inme sonrası nöbet gelişen olgularda klinik özellikler ve bu özelliklerin prognoz ile ilişkisi değerlendiril-miştir. Anterior sirkülasyon tutulum sıklığı erken ve geç nöbet gruplarında birbirine eşit bulundu (%78).…”

Pergolide-induced ergotism

“…In the literature, stroke severity was found to be a predictor of clinical poststroke seizures in some studies, [21][22][23][24] but not all. 25 Recent elec- trophysiologic studies using cEEG in patients admitted to an intensive care unit 7,8 did not find stroke severity to be a predictor of electrical epileptic seizures.…”