title: Incidence and predictors of acute symptomatic seizures after stroke.
abstract: OBJECTIVE
  To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke.
  
  
  METHODS
  Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors.
  
  
  RESULTS
  A total of 714 patients (315 women, 399 men; age 27-97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5-14.9) followed by CIHT (OR 2.7; 95% CI 0.8-9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8-20.8) and for CI (OR 3.1; 95% CI 1.3-7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03-0.8) was a protective factor for IPH.
  
  
  CONCLUSIONS
  The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke.
authors.affiliation: Dipartimento di Neuroscienze, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. ettore.beghi@marionegri.it
authors.forename: E
authors.initials: E
authors.lastname: Beghi
authors.forename: R
authors.initials: R
authors.lastname: D'Alessandro
authors.forename: S
authors.initials: S
authors.lastname: Beretta
authors.forename: D
authors.initials: D
authors.lastname: Consoli
authors.forename: V
authors.initials: V
authors.lastname: Crespi
authors.forename: L
authors.initials: L
authors.lastname: Delaj
authors.forename: C
authors.initials: C
authors.lastname: Gandolfo
authors.forename: G
authors.initials: G
authors.lastname: Greco
authors.forename: A
authors.initials: A
authors.lastname: La Neve
authors.forename: M
authors.initials: M
authors.lastname: Manfredi
authors.forename: F
authors.initials: F
authors.lastname: Mattana
authors.forename: R
authors.initials: R
authors.lastname: Musolino
authors.forename: L
authors.initials: L
authors.lastname: Provinciali
authors.forename: M
authors.initials: M
authors.lastname: Santangelo
authors.forename: L M
authors.initials: LM
authors.lastname: Specchio
authors.forename: G
authors.initials: G
authors.lastname: Zaccara
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000150:complications; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D020521:Stroke / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D013997:Time Factors