Acute symptomatic seizures in patients with recurrent ischemic stroke: A multicentric study

Area of Science:

• Neurology
• Stroke Medicine
• Epileptology

Background:

• Epileptic seizures are common post-stroke due to neurological changes.
• Stroke recurrence affects up to 10% of patients within the first year.
• Understanding seizure risk in recurrent stroke is crucial for patient management.

Purpose of the Study:

• To determine the risk of acute symptomatic seizures in patients experiencing recurrent stroke.
• To compare seizure incidence between first-ever and recurrent stroke events.
• To identify predictors of seizures in middle cerebral artery (MCA) stroke.

Main Methods:

• Retrospective cohort study of ischemic stroke admissions over 5 years.
• Included patients from two international centers for validation.
• Excluded patients with a prior epilepsy diagnosis.
• Logistic regression used to identify seizure predictors in MCA stroke.

Main Results:

• No significant difference in seizure risk between recurrent (5.1%) and first-ever stroke (4.5%) patients.
• Acute symptomatic seizure risk was also comparable (5.0% vs. 4.1%).
• Predictors for seizures in first MCA stroke (age, sex, hemorrhage) were not significant in recurrent stroke.

Conclusions:

• Previous stroke history is not associated with increased seizure risk during hospitalization.
• Further large-scale prospective studies with electrophysiological evaluation are warranted.
• Stroke recurrence does not appear to elevate acute seizure risk.