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Seizures after stroke : a prospective clinical study
A K Dhanuka1, U K Misra, J Kalita
1Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226014, India.
Neurology India
|April 17, 2001
Summary
Early seizures after stroke are common and do not lead to epilepsy. However, late-onset seizures in stroke patients are less frequent but often result in recurrent seizures and epilepsy.
Area of Science:
- Neurology
- Clinical Neuroscience
Background:
- Stroke is a leading cause of epilepsy in the elderly.
- Limited prospective research exists on post-stroke seizures, with most data from retrospective studies.
Purpose of the Study:
- To prospectively investigate the incidence, clinical features, radiological characteristics, and outcomes of seizures in stroke patients.
- To differentiate between early and late-onset seizures and their association with epilepsy development.
Main Methods:
- A 6-year prospective study of 269 consecutive stroke patients at a tertiary care center.
- Clinical evaluation, brain CT scans, and electroencephalography (EEG) were used to characterize seizures and lesions.
- Patients were followed up to assess seizure recurrence and epilepsy development.
Main Results:
- 13% (35/269) of stroke patients developed seizures, primarily related to stroke.
- Cortical involvement was common in patients with seizures (86% of lesions).
- Early-onset seizures (within 77% of cases) did not recur or lead to epilepsy, even without anti-epileptic treatment. Late-onset seizures (50% recurrence) were associated with epilepsy development. No specific EEG pattern predicted epilepsy.
Conclusions:
- Early post-stroke seizures are frequent, benign, and do not necessitate anti-epileptic treatment.
- Late-onset seizures after stroke are less common but indicate a higher risk of developing epilepsy and recurrent seizures.