Evaluation of Seizure After Stroke in Stroke Unit

Abstract

Objective: Patients with stroke may experience epileptic seizures as acute phase (usually defined as the first 15 days) or late phase complications. Risk factors are young age, male sex, cortical involvement and hemorrhagic transformation. Our aim was to investigate the etiologic factors and to determine the high-risk groups for the 1 year seizure rate of patients who are followed up in our clinic with a diagnosis of acute ischemic stroke. Materials and Methods: This study was included in a retrospective review of 299 patients who underwent regular out-patient clinic visits for 1 year followed by a diagnosis of acute ischemic stroke in the Department of Neurology at the Eskisehir Osmangazi University Faculty of Medicine between January 1st, 2012, and January 1st, 2015. Results: We found that thrombolytic therapy in patients with ischemic stroke decreased post-stroke seizure (p=0.043), whereas decompressive craniectomy (p=0.048), endovascular treatment (p=0.032), and cortical involvement (p=0.003) increased post-stroke seizures. Conclusion: According to our study, patients with cortical involvement, modified Rankin Scale score 4 and 5 at discharge, presence of major vascular occlusion treated with endovascular treatment, and those with decompressive craniectomy were high-risk groups. Prospective observational drug trials can be performed because double-blind placebo drug studies are not possible in high-risk groups.

Keywords

• Ischemic stroke
• seizure after stroke
• prophylactic antiepileptic treatment