Epileptic Seizures in Acute Stroke

TLDR

The study prospectively assessed the incidence of early seizures in 1,000 consecutive stroke and TIA patients to determine whether seizure occurrence correlates with stroke type, pathogenesis, or clinical outcome. Patients were followed from admission, and seizure occurrence within 48 h was recorded and analyzed in relation to stroke subtype, underlying pathology, and subsequent outcomes. Early seizures occurred in 4.4 % of patients, most frequently after lobar or extensive hemorrhage, subarachnoid hemorrhage, or cortical infarction, were usually single, partial, and controlled within 48 h, and were not associated with increased mortality, worse functional outcome, or with lacunar infarcts, deep hemorrhages, or cortical infarct pathogenesis.

Abstract

• We evaluated prospectively the incidence of early seizures in 1000 consecutive patients with stroke and transient ischemic attacks to determine whether seizure occurrence correlates with stroke type, pathogenesis, or outcome. Seizures occurred in 44 patients (4.4%; SE, 0.7%), including 10(15.4%) of 65 (SE, 4.5%) with lobar or extensive hemorrhage, 6(8.5 %) of 71 (SE, 3.3%) with subarachnoid hemorrhage, 24 (6.5%) of 370 (SE, 1.3%) with cortical infarction, and 4 (3.7%) of 109 (SE, 1.8%) with hemispheric transient ischemic attacks. Lacunar infarcts and deep hemorrhages were not associated with seizures. Arteriovenous malformation was a common cause of lobar hemorrhage with early seizures, but in cortical infarcts there was no association between seizure occurrence and pathogenesis. Seizures generally occurred within 48 hours of stroke onset, were usually single, partial, and readily controlled. Seizures were not associated with a higher mortality or worse functional outcome.