title: Are Early Seizures Predictive of Epilepsy after a Stroke? Results of a Population-Based Study.
abstract: BACKGROUND
  In addition to determining the cumulative incidence and risk factors for early seizures (ES), late seizures (LS) and post stroke epilepsy (PSE), we aimed at checking if ES represented a risk factor for epilepsy and if early treatment after ES prevented the occurrence of subsequent seizures.
  
  
  METHODS
  This study was part of a 2-year prospective community-based registry of all cerebrovascular events in the district of Udine (153,312 inhabitants), North-Eastern Italy, between April 1, 2007 and March 31, 2009. People with transient ischemic attacks (TIAs) were excluded from this study.
  
  
  RESULTS
  In all, 782 cases of stroke (79.28% ischemic, 14.83% hemorrhagic, 3.20% subarachnoid hemorrhage and 2.69% undetermined) were identified. The incidence of ES, LS and PSE was 5.10, 3.14 and 2.22%, respectively. Intracerebral hemorrhage, subarachnoid hemorrhage, stroke of undetermined origin and hyponatremia, represented risk factors for ES (p < 0.05). Among ischemic strokes, ES risk factors were hyponatremia (p = 0.024) and hemorrhagic transformation (p = 0.046). LS risk factors were younger age (p = 0.004) and cortical location of stroke (p = 0.004). Within ischemic strokes, LS risk factors were younger age (p = 0.020) and cortical location (p < 0.0001). Within intracerebral hemorrhages, the only risk factor for LS was the presence of a previous ES (p = 0.017). PSE risk factors were the same as for LS.
  
  
  CONCLUSIONS
  All acute conditions related to the occurrence of stroke are implicated in the pathogenesis of ES, which becomes a risk factor for LS only in the setting of intracerebral hemorrhages. Therefore, early antiepileptic treatment is needed only in this situation.
authors.affiliation: Neurology Unit, University-Hospital, University of Udine Medical School, Udine, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Serafini
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Gigli
authors.forename: Giorgia
authors.initials: G
authors.lastname: Gregoraci
authors.forename: Francesco
authors.initials: F
authors.lastname: Janes
authors.forename: Iacopo
authors.initials: I
authors.lastname: Cancelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Novello
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Valente
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004827:Epilepsy / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology*