Post-stroke seizure

OBJECTIVE: This study was designed to estimate the incidence of seizures in patients with stroke and its relative frequency with each type of stroke, to find the frequency of early and late seizures, recurrent seizure, and the EEG findings.

METHODS: This is a cross sectional study that enrolled 176 randomly selected patients with stroke admitted to Al-Yarmouk, Teaching Hospital, Baghdad, Iraq during the period between October 1998 and June 2001. Out of these, 42 patients with post-stroke seizure were chosen to undergo thorough clinical examination and investigations.

RESULTS: Seizures had been observed in 42 patients with stroke (23.9% of the sample). Single seizure without recurrence had been observed in 83.3% of those with post-stroke seizures (35 patients). Electroencephalograph results showed abnormal findings in 66.6% of those with post-stroke seizure (28 patients). Twenty-five patients (59.5%) of those with post-stroke seizure had ischemic stroke according to brain CT scan. In addition, this study revealed that 69.1% of the seizures were primary generalized seizures and 38.1% were partial seizures. In this study, it was found that 50% of the patients (21 patients) had early onset seizure, namely, within the first week, while only 14.3% of them had seizure during the 3rd week after the stroke event.

CONCLUSION: This study indicated that post-stroke seizures are quite a common problem in the management of patients with stroke but they are usually single without recurrence. Ischemic stroke is the most common cause of post-stroke seizure, and generalized seizure is the most common type. In addition, this study indicated that the initial 2 weeks after stroke carry the highest risk for stroke patients to have a seizure.