Early seizures in patients with acute stroke: frequency, predictive factors, and effect on clinical outcome.
BACKGROUND
Early seizure (ES) may complicate the clinical course of patients with acute stroke. The aim of this study was to assess the rate of and the predictive factors for ES as well the effects of ES on the clinical outcome at hospital discharge in patients with first-ever stroke.


METHODS
A total of 638 consecutive patients with first-ever stroke (543 ischemic, 95 hemorrhagic), admitted to our Stroke Unit, were included in this prospective study. ES were defined as seizures occurring within 7 days from acute stroke. Patients with history of epilepsy were excluded.


RESULTS
Thirty-one patients (4.8%) had ES. Seizures were significantly more common in patients with cortical involvement, severe and large stroke, and in patient with cortical hemorrhagic transformation of ischemic stroke. ES was not associated with an increase in adverse outcome (mortality and disability). After multivariate analysis, hemorrhagic transformation resulted as an independent predictive factor for ES (OR=6.5; 95% CI: 1.95-22.61; p=0.003).


CONCLUSIONS
ES occur in about 5% of patients with acute stroke. In these patients hemorrhagic transformation is a predictive factor for ES. ES does not seem to be associated with an adverse outcome at hospital discharge after acute stroke.
Alberti
Andrea
A
Stroke Unit and Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy. andrea_alberti@hotmail.com
Paciaroni
Maurizio
M
Caso
Valeria
V
Venti
Michele
M
Palmerini
Francesco
F
Agnelli
Giancarlo
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002545:Brain Ischemia; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology / Q000209:etiology*; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome