Poststroke epilepsy (PSE) is a feared complication after stroke and is reported in
3% to 5% of stroke survivors. In this study we sought to identify incidence and predictors
of PSE in an unselected stroke population with a follow-up period of 7 years. The
study was community-based and comprises a cohort of 1197 consecutively and prospectively
admitted patients with stroke. Patients were followed up for 7 years. We defined PSE
as recurrent epileptic seizures with onset after stroke and requiring antiepileptic
prophylaxis. PSE was related to clinical factors (age, sex, onset stroke severity,
lesion size on computed tomography scans, stroke subtype, localization, stroke risk
factor profile, and early seizures) in univariate analyses. Independent predictors
of PSE were identified through multiple logistic regression analyses. Overall, 38
patients (3.2%) developed PSE. Univariately, PSE was associated with younger age,
intracerebral hemorrhage, and larger lesions. PSE was less frequently associated with
atrial fibrillation and ischemic heart disease. In the final multiple regression model
for the dependent variable PSE, independent predictors were younger age (odds ratio
[OR] 1.7/10 years; 95% confidence interval [CI] 1.3-2.1), onset stroke severity (OR
1.3-/10-point decrease; 95% CI 1.0-1.6), lesion size (OR 1.2-/10-mm enlargement; 95%
CI 1.0-1.3), intracerebral hemorrhage (OR 3.3; 95% CI 1.3-8.6), and early seizures
(OR 4.5; 95% CI 1.3-16.0). We conclude that PSE occurs in about 3% of all patients
with stroke within 7 years after stroke. Age, intracerebral hemorrhage, lesion size,
increasing stroke severity, and early seizures are independent predictors of PSE.
Key Words
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Article info
Publication history
Accepted:
June 28,
2005
Received:
May 1,
2005
Footnotes
Supported by grants from the Danish Health Foundation, the Danish Heart Foundation, Ebba Celinders Foundation, the Independent Order of Odd Fellows, Scandinavia Lodge 2, and HjerneSagen.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2005.07.001
Copyright
© 2005 National Stroke Association. Published by Elsevier Inc. All rights reserved.
