title: Identifying patients at risk of acute symptomatic seizure after ischemic stroke.
abstract: BACKGROUND
  Contributors to post-stroke seizure research have advocated the need for prospective studies of acute symptomatic seizures after stroke. Identification of the patient at risk of seizure and the impact of the event on outcome is a prerequisite for this kind of research. The aim of this study was to identify risk factors, make an outline for a risk score, and look at consequences of seizure on short-time clinical outcomes.
  
  
  METHODS
  This registry-based study included patients with ischemic stroke admitted between 2007 and 2013. We identified variables associated with the presence of acute symptomatic seizures and made a risk score. Clinical outcome measures were modified Rankin scale, National Institute of Health Stroke Scale (NIHSS), and death at discharge or at day seven.
  
  
  RESULTS
  A total of 2598 ischemic stroke patients were included, 66 experiencing seizure within seven days of stroke. We found diabetes mellitus, NIHSS on admission, and cortical lesion to be associated with the risk of seizure. The risk score had a sensitivity of 58%, specificity of 85%, and a positive predictive value of 9% with a three-point cutoff. We found a negative effect of seizure on survival in mild-to-moderate strokes after adjusting for infections and stroke severity.
  
  
  CONCLUSIONS
  Because of low incidence and the lack of specific risk factors, acute symptomatic seizure after ischemic stroke is hard to predict. The negative effect of seizure on stroke outcome is uncertain, and more thorough studies are needed because of possible subtle or non-overt seizures.
authors.affiliation: Department for Geriatrics and Stroke, Medical Clinic, Haraldsplass Deaconess Hospital, Bergen, Norway.
authors.forename: K N
authors.initials: KN
authors.lastname: Alme
authors.affiliation: Department of Neurology, Haukeland University Hospital, Norway Institute of clinical medicine, Bergen, Norway.|University of Bergen, Bergen, Norway.
authors.forename: B A
authors.initials: BA
authors.lastname: Engelsen
authors.affiliation: Department for Geriatrics and Stroke, Medical Clinic, Haraldsplass Deaconess Hospital, Bergen, Norway.|University of Bergen, Bergen, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Naik
authors.affiliation: Department of Neurology, Haukeland University Hospital, Norway Institute of clinical medicine, Bergen, Norway.|University of Bergen, Bergen, Norway.|Centre for age-related medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Naess
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology; D020521:Stroke / Q000150:complications*
keywords: cerebrovascular disease; epilepsy; seizures; strokes