Frequency of seizures in post-cerebrovascular accident patients

To determine the frequency of seizures in patients following a cerebrovascular accident (CVA).

This prospective observational cohort study was carried out at the Department of Medicine, Faisal Masood Teaching Hospital, Sargodha, between July 2024 and April 2025. After ethical clearance and written consent, 73 adults of either gender, aged 20 to 70 years, who reached the hospital within 24 hours of an acute stroke were enrolled. Data were analyzed using SPSS version 26.0.

Mean age was 55.33 ± 14.32 years, with 43 men (58.9%) and 30 women (41.1%). Ischemic stroke was seen in 49 patients (67.12%) and hemorrhagic stroke in 24 (32.88%). The middle cerebral artery was the most common territory, with 30 cases (41.1%), followed by the anterior cerebral artery with 24 (32.88%), the posterior cerebral artery with 10 (13.7%), and the cortical area with 9 (12.33%). Post-stroke seizures developed in 40 patients (54.79%), with onset ranging from 2 to 49 days (mean 28.03 ± 14.66). Late-onset seizures occurred in 30 patients (41.1%) and early-onset seizures in 10 (13.7%). On binary logistic regression, anterior cerebral artery involvement was an independent predictor of seizures (OR 4.88, 95% CI 1.43-18.67, p = 0.014); all patients with posterior cerebral artery or cortical involvement developed seizures (complete separation, odds ratios not estimable), whereas age, gender, and stroke type were not significant (model AUC 0.84).

Seizures developed in over half of the stroke patients, and a late-onset pattern was more common. Cortical and posterior cerebral artery involvement showed the strongest association with seizures, and anterior cerebral artery involvement was an independent predictor of seizure occurrence.