Incidence of seizures in the acute phase of stroke: A population-based study

Authors: Szaflarski, Jerzy P.¹; Rackley, Angela Y.¹; Kleindorfer, Dawn O.¹; Khoury, Jane²; Woo, Daniel¹; Miller, Rosemary¹; Alwell, Kathleen¹; Broderick, Joseph P.¹; Kissela, Brett M.¹

Source: Epilepsia, Volume 49, Number 6, June 2008 , pp. 974-981(8)

Publisher: Wiley-Blackwell

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Abstract:

Summary

Purpose: The incidence of seizures within 24 h of acute stroke has not been studied extensively. We aimed to establish the incidence of acute poststroke seizures in a biracial cohort and to determine whether acute seizure occurrence differs by race/ethnicity, stroke subtype, and/or stroke localization.

Methods: We identified all stroke cases between July 1993 and June 1994 and in 1999 within the population of the Greater Cincinnati metropolitan region. Patients with a prior history of seizures/epilepsy were excluded from analysis.

Results: A total of 6044 strokes without a history of seizure(s) were identified; 190 (3.1%) had seizures within the first 24 h of stroke onset. Of ICH/SAH patients, 8.4% had a seizure within the first 24 h of stroke onset (p ≤ 0.0001 vs. all other stroke subtype). Of the patients with ischemic stroke, we observed higher incidence of seizures in cardioembolic versus small or large vessel ischemic (p = 0.02) strokes. Patients with seizures experienced higher mortality than patients without seizures (p < 0.001) but seizures were not an independent risk factor of mortality at 30 days after stroke. Independent risk factors for seizure development included hemorrhagic stroke, younger age, and prestroke Rankin score of ≥1. Race/ethnicity or localization of the ischemic stroke did not influence the risk for seizure development in the studied population.

Discussion: The overall incidence of acute seizures after stroke was 3.1%, with a higher incidence seen in hemorrhagic stroke, younger patients, and those presenting with higher prestroke Rankin scores. Acute seizures were associated with a higher mortality at 30 days after stroke.

Keywords: Stroke; Seizures; Acute stroke; Incidence; Epilepsy; ICH; SAH; Hemorrhage

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1528-1167.2007.01513.x

Affiliations: 1: Department of Neurology and the Neuroscience Institute, University of Cincinnati Academic Health Center, Cincinnati, Ohio, U.S.A. 2: Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.

Publication date: 2008-06-01

Incidence of seizures in the acute phase of stroke: A population-based study

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