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Association between poststroke epilepsy and death: A nationwide cohort study
Johan Zelano1,2, Petra Redfors1,2, Signild Åsberg3
1Department of Clinical neuroscience, University of Gothenburg, Sweden.
European Stroke Journal
|April 23, 2019
Summary
Poststroke epilepsy (PSE) significantly increases mortality risk after stroke. This nationwide study found PSE affects 7.3% of stroke survivors, highlighting the need for further research into its causes and management.
Area of Science:
- Neurology
- Epileptology
- Public Health
Background:
- Poststroke epilepsy (PSE) is a common acquired epilepsy in older adults.
- Understanding PSE's impact on prognosis and risk factors is crucial.
Purpose of the Study:
- To investigate the prognostic impact of poststroke epilepsy.
- To validate nationwide the risk of developing PSE.
Main Methods:
- Nationwide cohort study using Swedish national registries.
- Included patients surviving >2 months post-stroke without prior epilepsy.
- Cox proportional hazard models assessed mortality risk.
Main Results:
- PSE detected in 7.3% of 106,455 patients; higher incidence after intracerebral hemorrhage (12.4%) vs. ischemic stroke (6.4%).
- Stroke severity, intracerebral hemorrhage, and young age linked to PSE risk.
- PSE associated with a 1.68-fold increased risk of death, even after adjustments.
Conclusions:
- Increased mortality in PSE requires further investigation.
- Potential causes include seizure-related deaths, suboptimal secondary stroke prevention, or antiepileptic drug effects.
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