title: Epilepsy after TIA or stroke in young patients impairs long-term functional outcome: the FUTURE Study.
abstract: OBJECTIVE
  To determine the influence of poststroke epilepsy on long-term functional outcome in young stroke survivors.
  
  
  METHODS
  This study is a prospective cohort study among 537 stroke survivors with a first-ever TIA, ischemic stroke, or intracerebral hemorrhagic (ICH) stroke, aged 18 to 50 years. After a mean follow-up of 9.8 years (SD 8.4), we performed a follow-up assessment that included an evaluation for poststroke epilepsy and functional outcome. Odds ratios for poor outcome on the modified Rankin Scale (mRS) (score >2) and Instrumental Activities of Daily Living (IADL) (score <8) were calculated using logistic regression analysis.
  
  
  RESULTS
  Forty patients (12.7%) with ischemic stroke, 4 patients (2.2%) with TIA, and 10 patients (25.6%) with ICH developed poststroke epilepsy. Ischemic stroke patients with epilepsy more often had a poor functional outcome than those without, both on the mRS and IADL (mRS score >2: 27.5% vs 9.8%, p = 0.001; IADL <8: 27.8% vs 12.6%, p = 0.02). Epilepsy was not related to functional outcome in patients with TIA and ICH. Multiple regression analysis revealed that epilepsy was an independent predictor of poor functional outcome after ischemic stroke assessed by mRS (mRS score >2: odds ratio 3.38, 95% confidence interval 1.33-8.60). In contrast, there was no such relation for IADL.
  
  
  CONCLUSIONS
  Epilepsy after stroke in young patients is a common problem that negatively affects functional outcome, even more than 10 years after ischemic stroke.
authors.affiliation: From the Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.
authors.forename: Renate M
authors.initials: RM
authors.lastname: Arntz
authors.forename: Noortje A M
authors.initials: NA
authors.lastname: Maaijwee
authors.forename: Loes C A
authors.initials: LC
authors.lastname: Rutten-Jacobs
authors.forename: Hennie C
authors.initials: HC
authors.lastname: Schoonderwaldt
authors.forename: Lucille D
authors.initials: LD
authors.lastname: Dorresteijn
authors.forename: Ewoud J
authors.initials: EJ
authors.lastname: van Dijk
authors.forename: Frank-Erik
authors.initials: FE
authors.lastname: de Leeuw
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000523:psychology; D013997:Time Factors; D055815:Young Adult