Clinical and radiological profile of post-Stroke seizures

Abstract

Aims: To know the incidence of early versus late post stroke seizures, and its type and time of occurrence after the stroke as well as its relation with different type of stroke and location of the involvement and correlation with different risk factors along with to know occurrence early versus late post stroke seizures in young versus old stroke patients. Study Design: Observational study. Methodology: All the patients with the diagnosis of post-stroke seizures were included. Those with known epilepsy, sepsis, electrolyte imbalance, patient having old stroke presenting with fresh stroke and any other reversible precipitating factors were excluded. Data collected regarding the age, co-morbid conditions, details of seizures and radiological findings including type and location of stroke. Results: Total of 100 subjects with post-stroke seizures were included. Fifty eight percent were males while 42% were females. Mean age of the study population was 57.6 ± 15 years. Eighteen patients had young stroke ( 45 years. Early post-stroke seizures were seen in 54% of patients. Rest of the patients i.e. 46%, had late-seizures. GTCS were the most common type of seizures seen in 72% patients, followed by partial motor with secondary generalization and partial motor seen in 20% and 8% of the patients respectively. Sixty two percent of the patients had multiple episodes of seizures i.e. two or more than two episode while 38% had only single episode of seizure. Only 2% had status epilepticus. Eighty percent of the patient had Ischemic stroke while hemorrhagic stroke was seen in 20% of the patients. Sixty two percent of the patient had cortical location of stroke while 38% had subcortical location. Comparison between early and late onset seizures revealed significant association between ischemic heart disease (IHD) and hypertension with late onset seizures (p < 0.05). There was no significant difference in occurrence of early compared to late onset seizures in young and old patients. Conclusion: Post-stroke seizures were more frequent in males, older age with history of hypertension, and with cortical ischemic strokes. Early seizures, multiple episodes and generalized seizure type were more common. History of ischemic heart disease and hypertension showed a strong relationship with the occurrence of late onset seizures. Long term prospective studies are required to know whether control of hypertension and IHD may lead to decrease incidence of post stroke seizures. Keyword: Seizures, Stroke, Early versus Late Post stroke seizures