Clinical spectrum of post-stroke seizures.

Objective: To determine the characteristics of post-stroke seizures and compare these in early vs. late post-stroke seizures.

Study Design: Observational study.

Place And Duration Of Study: Department of Neurology, Liaquat National Hospital, Karachi, from March to September 2007.

Methodology: All admitted patients aged over 25 years, with diagnosis of post-stroke seizures were included. Those with known epilepsy, sepsis and electrolyte imbalance were excluded. Age, co-morbid condition, details of seizures and radiological findings regarding type and location of stroke were collected and entered in a pre-formed proforma. Results were described as frequency and mean. Association of variables was determined through chi-square test with significance at p < 0.05.

Results: Out of the 50 patients, there were 28 (56%) males and 22 (44%) females with the mean age of 56.86 ± 15.26 years. Thirty-one (62%) patients had history of hypertension. Early seizures i.e. within 2 weeks were seen in 29 (58%) patients. Generalized seizures were seen more frequently i.e. in 37 (74%) patients. Thirty-one (62%) subjects experienced more than 2 seizures. Forty (80%) had an ischemic stroke including 36 (72%) arterial infarct and 3 (6%) venous infarcts. Intracerebral hematoma was seen in 10 (20%) of subjects. Comparison between early and late onset seizures revealed significant association between ischemic heart disease (IHD), old stroke, hypertension and late onset seizures (p < 0.05).

Conclusion: Post-stroke seizures were more frequent in males, with history of hypertension, and with cortical ischemic strokes. Early seizures, multiple episodes and generalized seizure type were more common. Venous infarcts were chiefly associated with seizures at presentation. History of old stroke, ischemic heart disease, hypertension and hypercholesterolemia showed a strong relationship with the occurrence of late onset seizures.