Seizures after Ischemic Stroke: A Matched Multicenter Study.

Area of Science:

• Neurology
• Stroke Medicine
• Epileptology

Background:

• Post-stroke seizures, including acute symptomatic seizures and epilepsy, are common complications of ischemic stroke.
• Identifying risk factors is crucial for predicting and potentially preventing these seizures.

Purpose of the Study:

• To identify risk factors for acute symptomatic seizures and post-stroke epilepsy following acute ischemic stroke.
• To evaluate the impact of reperfusion treatments on the occurrence of seizures and epilepsy.

Main Methods:

• A multicenter study involving 4,229 adult patients with neuroimaging-confirmed ischemic stroke.
• Logistic or Cox regression analysis was used to assess risk factors.
• Propensity score matching was employed to compare seizure risk between patients with and without reperfusion treatment.

Main Results:

• Higher risk of acute symptomatic seizures was associated with more severe strokes, posterior cerebral artery territory infarcts, and large-artery atherosclerosis etiology.
• Post-stroke epilepsy risk factors included acute symptomatic seizures, stroke severity, cerebral cortex infarcts, and large-artery atherosclerosis.
• No association was found between reperfusion treatments (intravenous thrombolysis or mechanical thrombectomy) and the risk or timing of acute symptomatic seizures or post-stroke epilepsy.

Conclusions:

• Stroke severity, etiology, and infarct location are key predictors of post-stroke seizures and epilepsy.
• Early electroencephalogram findings were not predictive of epilepsy development.
• Reperfusion therapies did not alter the risk of acute symptomatic seizures or post-stroke epilepsy.