Risk factors for early-onset seizures after stroke: A systematicreview and meta-analysis of 18 observational studies

To systematically evaluate the risk factors of early-onset seizures after stroke, in order to better provide evidence-based results for early detection, identification, targeted prevention, and treatment of this disease.

PubMed, EMBASE, The Cochrane Library, CNKI, and WanFang databases were searched to collect relevant studies on the risk factors of early-onset seizures after stroke from January 2010 to January 2020. Meta-analysis of all included studies was performed by using RevMan version 5.3 and Stata version 14.0 software.

Eighteen case-control studies with a total sample size of 13,289 cases, including 813 cases with early-onset seizures after stroke, and 12,476 cases with non-early-onset seizures after stroke were included. The results of meta-analysis showed that cortical involvement [Odds Ratio (OR) = 5.00, 95%Confidence Interval (CI) (2.85, 8.74), p < .00001], cerebral infarction with hemorrhagic transformation [OR = 2.77, 95%CI (1.87, 4.11), p < .00001] and intracerebral hemorrhage [OR = 1.83, 95%CI (1.13, 2.97), p = .01]-related factors showed greater association with the occurrence of early-onset seizures after stroke.

These findings suggest that cortical involvement, intracerebral hemorrhage, and cerebral infarction with hemorrhagic transformation are important predictors and risk factors for early seizures after stroke, while the patient's gender, age, NHISS score, alcoholism, smoking, high blood pressure, diabetes, atrial fibrillation, dyslipidemia, receiving surgical treatment, and reperfusion therapy showed no association with the occurrence of early-onset seizures after stroke.