Predictive factors for early post-stroke seizures in a Hispanic population

Post-stroke seizures complicate diagnosis and treatment, worsen neurological outcomes, increase the risk of recurrence, and hinder recovery. Evidence in Hispanic populations is limited, so this study provides relevant data for clinical contexts in Latin America.

To identify predictive factors for early-onset seizures after a cerebrovascular event in a Hispanic population.

A retrospective, observational, cross-sectional study was conducted at a tertiary care health institution in Ecuador during the period 2024. Adult patients with a confirmed diagnosis of cerebrovascular event were included, selected by non-probabilistic sampling. Cases with a history of epilepsy, different structural causes, ambiguous events, or incomplete clinical records were excluded. The diagnosis of seizures was based on clinical evaluation and complementary studies such as an electroencephalogram (EEG). Binary logistic regression (95 % CI, margin of error 0.05) was used to identify predictive factors.

A total of 218 stroke patients were included, of whom 55 % (n = 120) had ischemic stroke and 45 % (n = 98) had hemorrhagic stroke. The average age was 62.9 years, and 65.6 % (n = 143) of the participants were men. Early post-stroke seizures occurred in 47.2 % (n = 103) of patients. Male sex showed a non-significant trend toward reduced seizure risk (Exp(B) = 0.524; adjusted p = 0.075), while diabetes mellitus was independently associated with an increased risk of seizures (Exp(B) = 3.542; adjusted p = 0.043). No significant associations were found with age, type of stroke, hypertension, history of previous stroke, or cortical involvement. Finally, hypertension was associated with a statistically significant delay in the time to onset of seizures after the cerebrovascular event (U = 1620; p = 0.015), with a median of 2 days (IQR: 1-3) in hypertensive patients.

Early seizures are a common post-stroke complication, particularly in women and patients with diabetes mellitus. This study, conducted in a Hispanic population, provides relevant evidence to improve management and prognosis in Latin American contexts. Early identification and management are crucial in reducing adverse outcomes.