Background: Post-stroke seizures or epilepsy (PSSz) may have significant consequences in patients already disabled from the brain insults. Few studies have explored their relation to stroke characteristics and outcomes.
Aim: We examined the association between post-stroke seizures and stroke characteristics as well as discharge outcomes among patients enrolled in a university hospital Stroke Registry.
Methods: Demographic, clinical, imaging and outcome data of patients with acute stroke treated at a University hospital were studied. Occurrence of seizures over a mean follow-up period of two years was noted. Above characteristics were compared among cohorts with and without PSSz. Statistical methods used included student's t test, chi square test and logistic regression analysis.
Results: Among 200 patients studied (age 64+13 yrs; M:F::1.6:1), 33 (16.5%) had seizures. 39% had large artery stroke, 10% cardioembolism and 27% small vessel disease. Most had <10 seizures; 3 patients had status epilepticus. 36 patients received IV rtPA. On univariate analysis, PSSz were associated with higher admission stroke
severity (NIHSS)(p=0.001), altered mental status (p=0.003), hemiparesis (p=0.013) and poor outcome at discharge (MRS 4-6) (p=0.01). On logistic regression analysis, PSSz were independently associated with greater stroke severity (higher NIHSS) at admission (p=0.003) and poor discharge outcome (p=0.014).
Conclusion: Post-stroke seizures are associated with significant clinical motor deficits, stroke severity as well as poorer discharge outcome. They may be markers of severe brain insults. Future studies should address specific interventions which may prevent occurrence of post-stroke seizures.

Post Stroke Seizures in a Stroke Registry: Association with Stroke characteristics and outcome