Early Seizures in Patients with Acute Ischemic Stroke: Incidence, Predictive Factors, and Clinical Outcome

Abstract

Objectives:Cerebrovascular disease is one of the major causes of epileptic seizures in the elderly. The aim of this study was to identify the incidence and predictive factors of early seizures after ischemic stroke (ESAIS) and the effect of early seizures on clinical outcome.Methods:The medical records of 619 patients with acute ischemic stroke were retrospectively reviewed. Early seizures were defined according to the International League Against Epilepsy within 7 days of stroke onset. Patient demographics, risk factors, National Institutes of Health Stroke Scale (NIHSS) score, thrombocyte count, and C-reactive protein (CRP) level on admission; modified Rankin Scale (mRS) score in the follow-up period; and details of the location of lesions observed on diffusion-weighted imaging were recorded and analyzed.Results:A total of 22 (3.6%) patients with ESAIS [10 females, 45.5%; mean age: 66.55±15.3 years (range: 35–91 years)] and 597 (85.5%) patients with non-ESAIS [280 females, 46.9%; mean age: 69.5±13.3 years (range: 23–103 years)] were included. The mean NIHSS score on admission, CRP level, thrombocyte count, in-hospital mortality, mean follow-up mRS, and the recurrent stroke rate were significantly higher in the ESAIS group (p<0.05). Logistic regression analysis revealed that only the NIHSS score on admission, thrombocyte count, and recurrent stroke rate were significantly associated with ESAIS (p<0.05).Conclusion:An elevated thrombocyte count and severe stroke on admission are possible major risk factors for ESAIS.

Keywords

• early seizures
• ischemic stroke
• predictive factors