Incidence of seizures in the acute phase of stroke: a population-based study.
OBJECTIVE
The incidence of seizures within 24 h of acute stroke has not been studied extensively. We aimed to establish the incidence of acute poststroke seizures in a biracial cohort and to determine whether acute seizure occurrence differs by race/ethnicity, stroke subtype, and/or stroke localization.


METHODS
We identified all stroke cases between July 1993 and June 1994 and in 1999 within the population of the Greater Cincinnati metropolitan region. Patients with a prior history of seizures/epilepsy were excluded from analysis.


RESULTS
A total of 6044 strokes without a history of seizure(s) were identified; 190 (3.1%) had seizures within the first 24 h of stroke onset. Of ICH/SAH patients, 8.4% had a seizure within the first 24 h of stroke onset (p <or= 0.0001 vs. all other stroke subtype). Of the patients with ischemic stroke, we observed higher incidence of seizures in cardioembolic versus small or large vessel ischemic (p = 0.02) strokes. Patients with seizures experienced higher mortality than patients without seizures (p < 0.001) but seizures were not an independent risk factor of mortality at 30 days after stroke. Independent risk factors for seizure development included hemorrhagic stroke, younger age, and prestroke Rankin score of >or=1. Race/ethnicity or localization of the ischemic stroke did not influence the risk for seizure development in the studied population.


CONCLUSIONS
The overall incidence of acute seizures after stroke was 3.1%, with a higher incidence seen in hemorrhagic stroke, younger patients, and those presenting with higher prestroke Rankin scores. Acute seizures were associated with a higher mortality at 30 days after stroke.
Szaflarski
Jerzy P
JP
Department of Neurology and the Neuroscience Institute, University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0525, USA. jerzy.szaflarski@uc.edu
Rackley
Angela Y
AY
Kleindorfer
Dawn O
DO
Khoury
Jane
J
Woo
Daniel
D
Miller
Rosemary
R
Alwell
Kathleen
K
Broderick
Joseph P
JP
Kissela
Brett M
BM
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D020766:Intracranial Embolism / Q000175:diagnosis / Q000453:epidemiology; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009820:Ohio; D011159:Population Surveillance; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D015996:Survival Rate