Poststroke Late Seizures and Their Role in Rehabilitation of Inpatients

Abstract

Summary:Purpose: This study was designed to (a) identify the prevalence of poststroke late seizures in a population of patients admitted to rehabilitation of neurologic sequelae of their first stroke, (b) recognize reliable prognostic factors associated with the occurrence of poststroke late seizures, and (c) evaluate the impact of seizures on the results of rehabilitation treatment.Methods: In a prospective study of 306 consecutive patients admitted to a rehabilitation hospital for sequelae of their first stroke, we assessed the relation among 15 independent variables and the development of seizures by using multiple regression analysis (forward stepwise). In addition, we evaluated the impact of occurrence of poststroke seizures on both efficiency and effectiveness of rehabilitation and length of stay.Results: Poststroke late seizures occurred in 46 (15.03%) patients, with a mean interval from stroke of 101.98 f 37.96 days. In multiple regression analysis, putaminal and lobar hemorrhages showed a significant positive association with the development of seizures (p < 0.005), whereas high scores on the Canadian Neurological Scale (CNS) (indicating less severe strokes) and increasing age were negatively associated (p < 0.01 and p < 0.05, respectively). Patients with putaminal and lobar hemorrhages and patients with severe stroke (CNS score at admission, <7) were at significantly greater relative risk of seizures [relative risk (RR) = 1.99, 95% confidence interval (CI), 1.11-1.39; RR = 3.00, CI, 1.06-1.13; and RR = 2.41, CI, 1.01-1.27, respectively). No significant association was found between poststroke seizures and results of rehabilitation.Conclusions: Poststroke late seizures occurred mainly in patients with putaminal and lobar hemorrhagic strokes but, if treated, did not affect rehabilitation therapy.

The CAVE Score for Predicting Late Seizures After Intracerebral Hemorrhage

“…1,[21][22][23] Despite the different design of these studies (mixed population of hemorrhagic and ischemic stroke), age below 65 years was revealed as a factor associated with seizures after ICH. Recently presented data on patient populations similar to ours also demonstrated an association of younger age with seizures.…”

Poststroke epilepsy: update and future directions

“…Other studies on small populations report varying results [Paolucci et al 1997;Bryndziar et al 2015]. Taken together, there may be room for improvement in management that should aim for seizure freedom in the same manner as in other forms of epilepsy.…”

Epileptic Seizures following Subcortical Infarcts

“…This explains the low mean age (57 years) of our series. Other series reporting a higher seizure prevalence after striatocapsular infarcts included patients with a higher median age [6, 7, 14]. …”