title: Early seizures in patients with acute stroke: frequency, predictive factors, and effect on clinical outcome.
abstract: 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.
authors.affiliation: Stroke Unit and Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy. andrea_alberti@hotmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Alberti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paciaroni
authors.forename: Valeria
authors.initials: V
authors.lastname: Caso
authors.forename: Michele
authors.initials: M
authors.lastname: Venti
authors.forename: Francesco
authors.initials: F
authors.lastname: Palmerini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Agnelli
mesh_terms: 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