Poststroke epilepsy: occurrence and predictors--a long-term prospective controlled study (Akershus Stroke Study).
OBJECTIVE
The aims of the study were to assess the occurrence of poststroke epilepsy (PSE) in patients with ischemic strokes, to identify predictors, and to investigate whether treatment in a stroke unit (SU) influenced the long-term outcomes of epilepsy.


METHODS
Patients with PSE, defined as those having two ore more unprovoked epileptic seizures > or = 1 week after an ischemic stroke, were identified from a cohort of 484 patients with ischemic strokes. The patients were prospectively assessed 7-8 years after stroke or until death. Different variables were studied to look for possible predictors.


RESULTS
From 484 patients with ischemic strokes, PSE developed in 12 (2.5%) and 15 (3.1%) patients during the first year and 7-8 years after stroke, respectively. Eight (53%) of these patients were treated in a stroke unit (SU), and seven (47%) were treated in a general medical ward (GMW). The mean age of those who developed PSE and those who did not was 74.3 years and 76.3 years, respectively. In a multivariate analysis, a Scandinavian Stroke Scale (SSS) score < 30 on admission was a significant predictor for developing PSE [odds ratio (OR), 4.9; p = 0.004).


CONCLUSIONS
The prevalence of PSE, 7 to 8 years after an ischemic stroke, was 3.1%. SSS scores < 30 on admission were a significant predictor for PSE. Neither treatment in SU versus GMW, cortical location, nor age at onset of stroke seemed to influence the risk of developing PSE.
Lossius
Morten I
MI
National Centre for Epilepsy, Sandvika, Norway. morten.lossius@epilepsy.no
Rønning
Ole M
OM
Slapø
Geir D
GD
Mowinckel
Petter
P
Gjerstad
Leif
L
D000367:Age Factors; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications*; D002423:Cause of Death; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009664:Norway / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D016896:Treatment Outcome
D000927:Anticonvulsants