title: Seizures Following Ischemic Stroke: Frequency of Occurrence and Impact on Outcome in a Long-Term Population-Based Study.
abstract: OBJECTIVE
  Seizures are a known complication of ischemic stroke (IS). This study assesses the long-term incidence and characteristics of poststroke seizures in a well-defined population.
  
  
  METHODS
  Using the Rochester Epidemiology Project medical records-linkage system, we identified all incident cases of IS among Rochester, Minnesota, residents from 1990 to 1994 and followed the patients in the comprehensive medical record through March 2014. All patients with poststroke seizures were identified, and data regarding incident IS, seizures, and status at last follow-up were analyzed.
  
  
  RESULTS
  We identified 489 patients with first IS. Mean follow-up was 6.5 (standard deviation 6.3) years. New onset seizures occurred in 35 patients (7.2%). Patients with poststroke seizure did not differ from those without in terms of IS etiologic subtype (P = .44) or IS risk factors (P > .05). Early seizures (within 14 days of index stroke) developed in 14 patients (40%), the majority within the first 24 hours (n = 9, 64.3%). The median time of seizure onset for the remaining 21 patients was 13.8 months. Functional outcome, as measured by modified Rankin Scale (mRS), was worse following development of poststroke seizures (mean mRS score 2.9 after IS, 3.3 following index seizure; P = .005), and mortality was higher as well, even after adjusting for IS etiologic subtype (HR 1.52, 95% confidence interval 1.07-2.16, P = .02).
  
  
  CONCLUSIONS
  Development of poststroke seizures is an infrequent but significant complication of IS, portending a worse short-term functional outcome and a higher long-term mortality rate. Seizure occurrence did not differ based on IS etiologic subtype or stroke risk factors.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota; International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic; Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Bryndziar
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota; International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic; Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Sedova
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Neha M
authors.initials: NM
authors.lastname: Kramer
authors.affiliation: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jay
authors.initials: J
authors.lastname: Mandrekar
authors.affiliation: International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic; Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Mikulik
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brown
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota. Electronic address: klaas.james@mayo.edu.
authors.forename: James P
authors.initials: JP
authors.lastname: Klaas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Stroke; TOAST; epidemiology; seizure