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Epileptic seizures in acute stroke.

C J Kilpatrick1, S M Davis, B M Tress

  • 1Department of Neurology, Royal Melbourne Hospital, Victoria, Australia.

Archives of Neurology
|February 1, 1990
PubMed
Summary

Early seizures occurred in 4.4% of stroke patients, primarily within 48 hours. These seizures, often partial and controlled, did not impact mortality or functional outcomes.

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Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Neurology

Background:

  • Early seizures are a potential complication following cerebrovascular events.
  • Understanding the incidence and predictors of seizures after stroke and transient ischemic attacks (TIAs) is crucial for patient management.

Purpose of the Study:

  • To prospectively evaluate the incidence of early seizures in patients with stroke and TIAs.
  • To determine if seizure occurrence correlates with stroke type, pathogenesis, or patient outcome.

Main Methods:

  • Prospective evaluation of 1000 consecutive patients diagnosed with stroke or TIAs.
  • Analysis of seizure occurrence in relation to stroke subtype (hemorrhage, infarction, TIA), specific causes (e.g., arteriovenous malformation), and patient outcomes.

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Main Results:

  • Seizures occurred in 4.4% of patients, with higher incidence in lobar hemorrhage (15.4%) and cortical infarction (6.5%).
  • Lacunar infarcts and deep hemorrhages were not associated with seizures.
  • Seizures typically occurred within 48 hours, were usually single, partial, and manageable, and did not correlate with increased mortality or worse functional status.

Conclusions:

  • Early seizures are relatively common after certain stroke types, particularly hemorrhagic and cortical infarcts.
  • The presence of seizures post-stroke does not appear to worsen long-term prognosis.
  • Arteriovenous malformation is a notable cause of seizures in lobar hemorrhage.