title: Prognostic value of early epileptic seizures on mortality and functional disability in acute stroke: the Dijon Stroke Registry (1985-2010).
abstract: We aimed to evaluate the prognostic value of early epileptic seizures after stroke. All consecutive patients with a first-ever stroke were prospectively identified within the population of Dijon, France, thanks to a population-based registry, from 1985 to 2010. Early epileptic seizures were defined as seizures occurring within 14 days after stroke onset. Outcomes were 1-month and 1-year mortality, and severe functional handicap at discharge. Of the 4,411 stroke patients included, data about seizures were available in 4,358 (98.8, 53.5 % women, mean age, 74.1 ± 14.8 years). Among these patients, 134 (3.1 %) had early seizures. Stroke patients with early seizures differed from those without seizures, as there was a higher proportion of hemorrhagic stroke, higher blood glucose level at admission, smoking status, and more frequent impaired. Higher risks of 1-month and 1-year mortality in patients with early seizures (unadjusted HR 1.45, 95 % CI 1.00-2.10; HR = 1.59, 95 % CI 1.21-2.09, respectively) disappeared (HR 0.71, 95 % CI 0.49-1.08 and HR 0.85, 95 % CI 0.64-1.17) after adjustment for stroke severity and other confounding factors. Early seizures were associated with severe handicap in unadjusted analyses (OR 2.07, 95 % CI 1.46-2.95) but the association was no longer significant after multivariable adjustment (OR 1.12, 95 % CI 0.69-1.83). Early epileptic seizures were not associated with higher risks of mortality at 1 month and 1 year or with unfavorable functional outcome after acute stroke. The adverse effects of epileptic seizures may not be distinguishable from stroke severity, which is strongly related to epileptic seizures.
authors.affiliation: Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon, University of Burgundy, CHU-3 Rue du Faubourg Raines, 21000 Dijon, France.
authors.forename: Bello
authors.initials: B
authors.lastname: Hamidou
authors.forename: Corine
authors.initials: C
authors.lastname: Aboa-Eboulé
authors.forename: Jérôme
authors.initials: J
authors.lastname: Durier
authors.forename: Agnès
authors.initials: A
authors.lastname: Jacquin
authors.forename: Martine
authors.initials: M
authors.lastname: Lemesle-Martin
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.forename: Yannick
authors.initials: Y
authors.lastname: Béjot
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D006233:Persons with Disabilities; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D016019:Survival Analysis