A comparative study of seizures in arterial and venous stroke

Abstract

ObjectiveThis study was undertaken to compare the frequency, spectrum and predictors of seizures in arterial stroke and cerebral venous sinus thrombosis (CVST). MethodsThe patients having seizures following arterial stroke or CVST during 2010–2015 were included. Stroke was confirmed by computerized tomography (CT) scan, magnetic resonance imaging (MRI) and or MR Venography (MRV). The seizures were categorized into early seizures (<14days) and late seizures (≥14days) of arterial stroke or CVST. Neurological findings, risk factors for stroke and CVST were noted. The severity of stroke was defined by National Institute of Health Stroke Scale (NIHSS). The outcome on discharge was assessed by modified Rankin Scale (mRS) as good (0–2) or poor (>2). ResultsThere were 870 patients with arterial stroke and 128 with CVST. Seizures occurred in 74 (57.8%) of CVST and 119 (13.7%) of arterial stroke. Early seizures were more common in CVST than arterial stroke (98.6% vs. 47.9%, p=0.001) whereas late seizures were more common after arterial stroke than CVST (52.1% vs. 1.4%, p=0.001). In the arterial stroke, seizures were predicted by carotid territory ischemic stroke (OR 3.95, 95% CI 1.51–10.32, p=0.005) and CVST by parenchymal involvement (OR 2.61, 95% CI 1.04–6.55, p=0.04) ConclusionCVST results in more frequent and early seizures whereas in arterial stroke late seizures are common. Post stroke seizures in ischemic stroke were predicted by carotid territory infarction and venous stroke by parenchymal involvement.