Poststroke Epilepsy Is Associated With a High Mortality After a Stroke at Young Age

Abstract

Background and Purpose-Poststroke epilepsy is a common complication after a young stroke. We investigated the association between poststroke epilepsy and mortality. Methods-We performed a prospective cohort study among 631 patients with a first-ever transient ischemic attack or ischemic stroke, aged 18 to 50 years. Survival analysis and Cox proportional hazard analysis were used to estimate cumulative mortality and hazard ratios for patients with and without epilepsy. Results-After mean follow-up of 12.5 years (SD 8.6), 76 (12.0%) developed poststroke epilepsy. Case fatality was 27.4% for patients with poststroke epilepsy and 2.1% for those without. Poststroke epilepsy was associated with 30-day mortality (hazard ratio, 4.8; 95% confidence interval, 1.7-14.0) and long-term mortality (hazard ratio, 1.8; 95% confidence interval, 1.2-2.9). Conclusions-Epilepsy is a common problem after a young stroke and is associated with an increased short-term and longterm mortality.

Seizures, electroencephalographic abnormalities, and outcome of ischemic stroke patients

“…In our bivariate analysis, seizures were associated with an unfavorable functional outcome 1 year after stroke, as previously suggested in the literature . It has been postulated in the animal model that poststroke seizures may contribute to tissue damage .…”

“…Poststroke epileptic phenomena (seizures and status epilepticus) have been associated with ischemic stroke unfavorable outcome. However, although electroencephalography (EEG) is essential for the detection of interictal and ictal epileptiform activity, it is unknown whether these EEG activities per se are also associated with stroke prognosis.…”

Epileptic manifestations in stroke patients treated with intravenous alteplase

“…Seizures after stroke have been associated with higher risks of mortality and disability [31][32][33][34][35]. This has also been observed in rare clinical studies about the effect of post-stroke seizures on functional outcome in the subgroup of patients treated with rtPA.…”

Epilepsia partialis continua after an anterior circulation ischaemic stroke

“…The consequences of post‐stroke EPC are unknown although post‐stroke epileptic phenomena (seizures and status epilepticus) have been associated with a worse infarct outcome.…”