The incidence rate of post-stroke epilepsy: a 5-year follow-up study in Taiwan.

Purpose: The impact of epilepsy following different subtypes of stroke is unclear. The aim of this study was to evaluate the risk of post-stroke epilepsy with different stroke subtypes.

Methods: A total of 4126 stroke patients and 24,756 age- and sex-matched controls were retrieved from the Longitudinal Health Insurance Database 2005, a major dataset of the National Health Insurance Research Database, from 2000 to 2003. All were then individually tracked to their last medical visit up to five years from 30 days after their first-ever stroke incident to identify those who developed epilepsy.

Results: Among the 4126 stroke patients, 72.2% had ischemic stroke, 14.7% had intracerebral hemorrhage (ICH), 2.3% had subarachnoid hemorrhage (SAH), 2.0% had other and unspecified intracranial hemorrhage (OIH), including subdural hemorrhage and epidural hemorrhage, and 8.9% had multiple stroke subtypes. The adjusted hazard ratio for the development of epilepsy was 11.5 (95% CI 8.2-16.2) for the patients with stroke compared to the controls. 2.6% of the patients with stroke developed epilepsy during the 5-year follow-up period. The rate of post-stroke epilepsy was highest in patients with multiple subtypes (7.7%), followed by ICH (4.3%), SAH (4.2%), OIH (2.5%) and ischemic stroke (1.6%).

Conclusion: Stroke patients had a significantly higher risk of developing epilepsy than the controls. The risk of post-stroke epilepsy was higher in patients with hemorrhagic stroke than ischemic stroke.