Post-Stroke Seizures: Frequency, Predictors and Health Impact (Clinical And Epidemiological Study)

Background: Post-stroke seizures (PSS), a common complication of cerebrovascular stroke (CVS), are classified into early post-stroke seizures (EPSS) and late post-stroke seizures (LPSS). Identifying the frequency, predictors, and health impact of PSS is crucial for optimal post-stroke management. Objective: To determine the risk factors, frequency, and PSS predictors, particularly LPSS, and to assess their impact on clinical and functional outcomes in stroke patients. Patients and methods: This nested case-control study included 422 stroke patients from two Egyptian university hospitals, with 115 developing PSS (20 EPSS, 95 LPSS) and 307 serving as controls. Patients were assessed for clinical and neuroimaging factors, metabolic profiles, and stroke severity using Barthel Index (BI). Results: Among 1,530 stroke patients, 11.6% developed seizures (5.4% EPSS and 6.2% LPSS). Predictors for LPSS included diabetes mellitus (95% CI = 1.06–4.46, P = 0.044), ischemic stroke (95% CI = 1.05–2.12, P = 0.044), psychotic manifestations (95% CI = 1.27–3.87, P = 0.037), and cortical lesions (95% CI = 1.08–4.90, P = 0.046). Interestingly, hypercholesterolemia (P = 0.041) and hypertriglyceridemia (P = 0.039) were protective against LPSS. LPSS patients had poorer functional outcomes, with 68.4% showing poor/very poor BI scores. Conclusion: LPSS occurs in 6.2% of stroke patients, with diabetes, psychosis, ischemic stroke, and cortical lesions identified as significant predictors. Elevated cholesterol and triglycerides may have a protective role. LPSS is associated with worse clinical and functional outcomes.