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Seizures More Common After Hemorrhagic Than Ishaemic Stroke
A DGReview of :"Seizures After Stroke: A Prospective Multicenter Study"
Archives of Neurology
11/28/2000
By Mark Greener
Seizures are more common following hemorrhagic than ishaemic strokes, report researchers from various centres in Canada, Israel, Australia and Italy.
Only about one in forty stroke patients, however, develops epilepsy.
The study enrolled 2021 patients with acute stroke. Of these, 124 patients were excluded either because they had a history of epilepsy or because they did not undergo diagnosis by computed tomography. Researchers followed patients for an average of nine months.
Overall, 8.9 percent of stroke patients had seizures. Seizures were more common among patients who had hemorrhagic than those who had ischaemic strokes (10.6 and 8.6 percent, respectively). Kaplan-Meier survival analysis estimated that patients with hemorrhagic stroke were almost twice as likely to had seizures (hazard ratio 1.85) than those who experienced ischaemic strokes.
Multivariate analysis suggested that cortical infarction (hazard ratio 2.09) and stroke disability (hazard ratio 2.10) predicted seizure risk following ischaemic stroke. Cortical infarction was the only risk factor for seizures after hemorrhagic stroke (hazard ratio 3.16).
Moreover, 2.5 percent of patients developed epilepsy (recurrent seizures). Late onset of first seizure independently predicted the risk of developing epilepsy after ischaemic (hazard ratio 12.37), but not hemorrhagic, stroke.
The authors concluded that seizures are more common following hemorrhagic than ischaemic stroke. However, only a small minority of stroke patients develop epilepsy.
"Seizures After Stroke: A Prospective Multicenter Study"
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