Abstract
Background: About 11% of all epilepsies and 30% of newly diagnosed seizures in those older than 60 years have been reported to follow cerebrovascular accidents. Acute symptomatic (early) seizures occur in 3-8% of patients, more commonly in those with severe cortical strokes and intra-parenchymal hemorrhages. This study was undertaken to determine the incidence, risk factors and clinical outcome for early seizures after acute stroke.Aims and objectives: To study the incidence, risk factors and clinical outcomes of early seizures in post stroke patients in a tertiary care hospital.Study design: This prospective observational analytical study was conducted from -01-06-2017 to 31-01-2019 in Max Superspeciality Hospital Saket New Delhi. All consecutive patients of acute stroke fulfilling the inclusion and exclusion criteria were included in the study. Inclusion criteria and exclusion criteria: All patients with acute ischemic or hemorrhagic stroke with age above 18 years, either male or female were included in the study. Patients with a history of seizure or epilepsy before admission, patients with SAH, venous infarct and causes other than vascular origin were excluded from the study. Results and observation: Out of two hundred and fifty (n=250) patients of acute stroke included in the study early seizures were diagnosed in 29 patients (11.6%).Conclusions: We concluded that the incidence of post stroke early seizures was 11.6% in our study. We found that Patients with post stroke early seizures had higher NIHSS score, low GCS score and higher modified Rankin score at the time of admission. We recommend that stroke scores like NIHSS, ICH, GCS and mRS should be applied to all the patients of acute stroke to stratify the patients with regard to their risk of developing early seizures and prognosticating the clinical outcome.
Highlights
About 11% of all epilepsies and 30% of newly diagnosed seizures in those older than 60 years have been reported to follow cerebrovascular accidents[1]
Their odds ratio were worked out along with the 95% confidence interval and statistical significance was at 5% level Secondary outcome: Clinical outcome were measured including mortality and disability at discharge according to Modified Rankin Score. modified Rankin Scale (mRS) 0,1,2 was taken as nondisabling stroke and 3,4, as disabling stroke Statistical Methods: Incidence of early seizures were worked up as percentage of total cases of stroke that will have seizures within 7 days
We found that 45.6% had cortical, 29.2% had subcortical and 13.2% had combined cortical and subcortical involvement.When the area of infarct was compared in patients of acute stroke with and without early seizures, it was found that 58.8% of patients of early seizures (n = 10) had combined cortical and subcortical involvement which is statistically significant
Summary
About 11% of all epilepsies and 30% of newly diagnosed seizures in those older than 60 years have been reported to follow cerebrovascular accidents[1]. This study was undertaken to determine the incidence, risk factors and clinical outcome for early seizures after acute stroke. Incidence and outcome of early post stroke seizures in a tertiary care hospital in New Delhi.... Dar MA etal ; Incidence and outcome of early post stroke seizures in a tertiary care hospital in New Delhi. Seizures are defined when they appear within the first 7 days after acute stroke onset 5. Aims and objectives: To study the incidence, risk factors and clinical outcomes of early seizures in post stroke patients in a tertiary care hospital. Primary objective: To determine the risk factors of early seizures in post stroke patients.
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