Risk factors for seizures after first-time ischemic stroke by magnetic resonance imaging.
BACKGROUND
Seizures are important neurological complications of ischemic stroke. There is a need to further clarify the risk factors of seizures following ischemic stroke and predict those who will require treatment.


METHODS
One hundred and forty-three (143) first-time ischemic stroke patients were enrolled in this one-year (2002) retrospective study. Prognostic variables were analyzed based on the Cox's proportional hazards model after a minimum follow-up period of six years.


RESULTS
Seizures occurred in 13 first-time ischemic stroke patients, including acute symptomatic seizures in two (1.4%) and unprovoked seizures in 11 (7.7%). Only one progressed to status epilepticus during hospitalization. After six years of follow-up, the median (inter-quartile range) Glasgow Outcome Scale (GOS) was 3 (3,4) for patients with seizures and 4 (3,4) for those without seizures. Regarding seizure control after discharge in the 13 cases, 12 were seizure-free with or without anti-epileptic drugs and one had 1-3 seizures per year. Only the presence of cortical distribution of ischemic infarction (p=0.009, OR=5.549, 95% CI=1.53-20.19) was independently associated with seizures by the Cox's proportional hazards model.


CONCLUSIONS
The incidence of seizures following first-time ischemic stroke is low and may have delayed manifestation. Cortical distribution of the ischemic infarction is a risk factors for seizures.
Chiang
I-Hui
IH
Department of Family Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang
Wen-Neng
WN
Lin
Wei-Che
WC
Chuang
Yao-Chung
YC
Chang
Ku-Chou
KC
Tsai
Nai-Wen
NW
Liou
Chia-Wei
CW
Sun
Tzu-Kuan
TK
Loke
Song-Seng
SS
Chen
Chao-Tung
CT
Huang
Chih-Fang
CF
Huang
Wei-Cheng
WC
Wang
Pei-Ming
PM
Lu
Cheng-Hsien
CH
D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis; D002540:Cerebral Cortex / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012640:Seizures / Q000209:etiology*; D020521:Stroke / Q000150:complications* / Q000175:diagnosis