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Background: Stroke is the leading cause of
epilepsy after the age of 60. The published
incidence of post-stroke seizures and epilepsy
varies from 4.4 to 42.8% according to different
study designs.
Methods: Our semi-prospective study included
599 first-ever stroke cases admitted
to our hospital between January 2002 and
December 2004. Patients with a prior history
of stroke, epilepsy, haemorrhagic stroke or
other possible causes of epilepsy (e.g. brain
tumour, alcohol dependence) were excluded
from the study.The follow-up period to identify
stroke-related seizures was of a minimum
of 36 months, in average 49.5 months. Poststroke
epilepsy was related to clinical factors
(age, sex, onset stroke severity, lesion size,
localisation, stroke subtype and stroke-risk
factor profile) and divided into “early onset”
and “late onset” seizures occurring either
within 7 days or more than one week after
stroke, respectively.
Results: Of all patients, 5.18% developed
seizures after stroke, of whom 2.18% experienced
a single epileptic seizure and 3.0%
developed epilepsy with recurrent seizures.
Early-onset seizures were detected in 25.8%
and late-onset seizures in 74.2%. Predictors
for developing vascular epilepsy are severity
of initial neurological impairment, large lesions
with cortical involvement and anterior
circulation syndrome. No significant differences
were observed in clinical predictors
between early- and late-onset seizures, neither
in single seizure nor in epilepsy. But a
larger number of patients with late-onset
seizures developed epilepsy.
Conclusion: We found a rather low incidence
of 5.18% of post-stroke seizures, which
may be due to our strict exclusion criteria
for potential epileptogenic pre-morbidities.
In other studies this may be overestimated.
As others, we also found more severe neurological
impairment, large lesions with cortical
involvement and anterior circulation syndrome
to be predictive factors for post-stroke
seizures.