title: Young adult ischaemic stroke related acute symptomatic and late seizures: risk factors.
abstract: OBJECTIVE
  After first-ever ischaemic stroke, to assess the risk and baseline factors associated with acute symptomatic seizure (ASS) (occurring within 7 days) and late post-stroke seizure (LPS) (>7 days).
  
  
  METHODS
  All consecutive patients aged 15-49 with first-ever ischaemic stroke between 1994 and 2007 treated at the Helsinki University Central Hospital were included, using Cox proportional hazard models to identify factors associated with seizures. Adjustment was for age, gender, vascular risk factors, admission hyperglycemia (>6.1 mm) and hyponatremia (<137 mm), use of psychiatric medication, stroke severity (NIH Stroke Scale) and anatomical (Bamford criteria) and etiological (Trial of Org in Acute Stroke Treatment) stroke subtype.
  
  
  RESULTS
  ASSs emerged in 35 (3.5%) patients. LPSs (n = 102) occurred at a cumulative rate of 6.1% at 1 year, 9.5% at 5 years and 11.5% at 10 years. In multivariate analysis, anxiolytic use at time of index stroke (hazard ratio 13.43, 95% confidence interval 3.91-46.14), moderate stroke severity (3.95, 1.86-8.41), cortical involvement (3.69, 1.66-8.18) and hyponatremia (3.26, 1.41-7.57) were independently associated with ASSs. Risk factors for LPSs were total anterior circulation infarct (15.94, 7.62-33.33), partial anterior circulation infarct (3.48, 1.52-7.93), history of ASS (3.94, 2.07-7.48), antidepressant use at the time of LPS (3.88, 2.46-6.11), hemorrhagic infarct (1.94, 1.19-3.15), male gender (1.79, 1.10-2.92) and hyperglycemia (1.62, 1.05-2.51).
  
  
  CONCLUSIONS
  In young ischaemic stroke patients, the magnitude of seizure risk and the major risk factors were similar to older ischaemic stroke patients but risk factors for ASSs and LPSs differed.
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. reina.roivainen@hus.fi
authors.forename: R
authors.initials: R
authors.lastname: Roivainen
authors.forename: E
authors.initials: E
authors.lastname: Haapaniemi
authors.forename: J
authors.initials: J
authors.lastname: Putaala
authors.forename: M
authors.initials: M
authors.lastname: Kaste
authors.forename: T
authors.initials: T
authors.lastname: Tatlisumak
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012640:Seizures / Q000209:etiology*; D020521:Stroke / Q000150:complications*; D013997:Time Factors; D055815:Young Adult
keywords: brain infarction; cerebrovascular disease; depression; epilepsy