title: Risk factors for post-stroke seizures: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis to identify risk factors associated with early seizure (ES) or late seizure (LS) onset in adults following stroke.
  
  
  METHODS
  Electronic databases (MEDLINE and EMBASE), archives of stroke or epilepsy patients, and bibliographies of relevant articles, which were written in English.
  
  
  METHODS
  We included studies published since 1990 that reported the stroke and seizure outcomes of adult patients during follow-up. We independently performed title, abstract and full-text screening and resolved disagreements through discussion.
  
  
  METHODS
  Two authors performed the data extraction. We recorded all possible risk factors predictive of seizure onset.
  
  
  RESULTS
  We used odds ratios (ORs) or the mean difference (MD) to compare the pooled rates of seizure onset between the exposed group and the non-exposed group. All meta-analyses were performed with Review Manager Software.
  
  
  RESULTS
  Intracerebral hemorrhage (OR=1.88, 95% CI=1.43-2.47), cerebral infarction with hemorrhagic transformation (OR=3.28, 95% CI=2.09-5.16), stroke severity (OR=3.10, 95% CI=2.00-4.81, p<0.01, I(2)=0%; MD=3.98, 95% CI=1.06-6.90, p<0.01), and alcoholism (OR=1.70, 95% CI=1.23-2.34, p<0.01) were associated with a significantly greater probability of ES occurrence. There were significant effects of cortical involvement (OR=2.50, 95% CI=1.93-3.23) and stroke severity (MD=5.72, 95% CI=4.23-7.22, p<0.01, I(2)=0) on LS onset. However, there was no significant difference in the probability of single LS episode between patients with intracerebral hemorrhage and infarction stroke (OR=1.20, 95% CI=0.92-1.55).
  
  
  CONCLUSIONS
  Evidence suggests that cortical involvement, stroke subtypes and stroke severity are significant predictors of seizure onset following stroke. However, we did not find a significant difference in the rate of onset of single LS episodes between patients with intracerebral hemorrhage and cerebral infarction.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China.
authors.forename: Xiu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China.
authors.forename: Jian-guo
authors.initials: JG
authors.lastname: Zhang
authors.affiliation: Beijing Neurosurgical Institute, Tiantan xili 6, Dongcheng, Beijing 100050, China.
authors.forename: Wenhan
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Ge
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China. Electronic address: zhangkai62035@163.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Tiantan xili 6, Dongcheng, Beijing 100050, China. Electronic address: xiaoqiushao@126.com.
authors.forename: Xiaoqiu
authors.initials: X
authors.lastname: Shao
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications; D002544:Cerebral Infarction / Q000150:complications; D006801:Humans; D012307:Risk Factors; D012640:Seizures / Q000209:etiology*; D020521:Stroke / Q000150:complications*
keywords: Cerebral infarction; Epilepsy; Intracerebral hemorrhage; Meta-analysis; Seizures; Stroke