Early post-stroke seizures following thrombolysis and/or thrombectomy for acute stroke: clinical and stroke characteristics We explored the clinical and stroke characteristics of patients treated with thrombolysis and/or mechanical thrombectomy for an acute stroke and experiencing early post-stroke seizures within 7 days of the cerebrovascular accident. Patients with prior epilepsy, primary intracerebral hemorrhage or transient ischemic attacks, and taking antiepileptic drugs were excluded. We retrospectively identified 32 patients admitted between 2010 and 2016 (mean age 75 years; range: 49-90; 14 females and 18 males). Most patients did not have a prior history of stroke (18; 56.3%), alcoholism (30; 93.8%) or diabetes (19; 59.4%); did not take statins (19; 59.4%) or anticoagulants (29; 90.6%); had a diagnosis of hypertension (30; 93.8%). Half of them (16; 50%) was treated with antiplatelet agents. 71.9% of strokes (23) had a cortical involvement, 12.5% (4) were subcortical and 15.6% (5) lacunar. Median NIHSS- and Rankin-score on admission were 12 and 4, respectively. 25 patients were treated with intravenous and 7 with intra-arterial thrombolysis, whereas 16 underwent thrombectomy. An hemorrhagic transformation occurred in 7 (21.9%) patients, and an hemorrhage following thrombolysis in 6 (18.8%). Focal-onset aware seizure (not secondarily generalized) was the most frequent seizure type (46.7%), followed by primarily generalized (43.3%), and focal unaware seizure (6.7%). No case of status epilepticus was observed. The median time between stroke and seizure occurrence was 2 days; in 75.9% of cases seizures occurred within the first 3 days. Early post-stroke seizures are associated with cortical stroke involvement, are usually focal without impairment of awareness, and occur mostly within the first 3 days.
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