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Published on: February 10, 2020
Poststroke seizures in stroke rehabilitation patients
R W Teasell1, M P McRae, S Wiebe
1Department of Physical Medicine, London Health Sciences Centre, London, Ontario, Canada.
Summary
Poststroke seizures (PSS) affect nearly 8% of stroke rehabilitation patients, with higher incidence in hemorrhagic strokes and those with cortical involvement. A history of seizures significantly increases the risk of developing PSS.
Area of Science:
- Neurology
- Stroke Rehabilitation
- Epileptology
Background:
- Stroke is a leading cause of acquired epilepsy.
- Understanding the incidence and characteristics of poststroke seizures (PSS) is crucial for patient management in rehabilitation settings.
- Previous studies have varied in their focus on specific stroke types or patient populations.
Purpose of the Study:
- To investigate the incidence, seizure types, and timing of poststroke seizures (PSS) in a stroke rehabilitation population.
- To compare the incidence of PSS across different stroke types (infarction vs. hemorrhagic) and locations (hemispheric vs. brainstem).
- To determine the impact of a prior seizure history on the risk of developing PSS.
Main Methods:
- A cohort of 549 stroke rehabilitation patients without a prior history of seizures was analyzed.
- Data collected included stroke type, location, seizure occurrence (PSS), seizure characteristics, and timing.
- Statistical comparisons were made between different stroke subtypes and patient groups.
Main Results:
- The overall incidence of PSS was 7.8% (43 of 549 patients).
- Incidence was significantly higher in hemorrhagic strokes (21.2%) compared to infarcts (4.9%), and in hemispheric strokes (9.3%) versus brainstem strokes (0%).
- A history of seizures significantly increased the risk of PSS (42.9% vs. 7.8%).
Conclusions:
- Poststroke seizures are a significant complication in stroke rehabilitation, particularly following hemorrhagic strokes and those with cortical involvement.
- Early recognition and management of PSS are important, as a majority occur within the first year post-stroke.
- Patients with a prior history of seizures are at a substantially higher risk for developing PSS.
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