Post Stroke Seizure in Group of Hospitalized Patient in Baghdad Teaching Hospital

Abstract

Background: Stroke is the most common causes of seizures in adulthood. The incidence of seizures after stroke varies widely between 3.7% to 42.8%. Objectives: To assess the incidence of post – stroke seizures, the time of onset of seizures and, the type of seizures, also to evaluate the relationship between the development of seizures with subtypes of stroke, stroke size, and stroke site. Patients and methods: Data of 380stroke patients were collected consecutively in Baghdad Teaching Hospital from Oct. 2013 to Nov. 2014; age, sex, date of stroke, symptoms and signs of stroke, time of seizures onset, patterns of seizures, neuroimaging findings, and the findings of both carotid Doppler and echocardiography were studied in both ischemic and hemorrhagic stroke. . Statistical analyses were performed using the SPSS software package for Windows 6.0. Results: Post – stroke seizures were developed in (9.73%) of our patients, furthermore, (8.5%) of patients with ischemic stroke and (18%) of patients with hemorrhagic stroke developed seizures. early onset seizures occurred in (56.76%) of patients with post – stroke seizures, while (71.43%) developed seizures within the first 24 hours. status epilepticus was seen in (10.8%). partial seizures developed in (61.9%) of patients with early onset seizures, while, (75%) of patients with late onset seizures had Secondarily generalized seizures. post – stroke seizures were occurred in (81.1%) of patients with cortical lesions, (P< 0.00005). Also (20%) of patients with large size lesion developed seizures, while (5.3%) of patients with small lesion developed seizures, (P < 0.0002). Post – stroke seizures developed in; (17.53%), (6.06%), (1.47%), of patients with embolic, thrombotic, and lacunar subtype of stroke, (P = 0.0004). Conclusions: The post – hemorrhagic stroke seizures more frequently within the first 24hr after the onset of stroke, while the post – ischemic stroke seizures occur equally at early onset and at late onset seizures, early onset seizures are more likely to be simple partial seizures, while late onset seizures are more likely to be secondarily generalized, further more status epilepticus occur more frequently within the first week after the onset of stroke. The hemorrhagic stroke, the embolic stroke, the cortical lesion and the large size lesion are associated with a higher risk for the development of the post – stroke seizures.