Abstracts

Rationale: Seizures are well-recognized complications after stroke. However, the reported incidence varies and so does its management Methods: Observational studies from various databases that reported incidence of seizures following arterial ischemic stroke in adults, and those that reported treatment response to any particular anti-epileptic drugs (AEDs) in these patients were included. Study quality was assessed by pre-specified quality measures. Random effects meta-analysis was conducted for all studies where data was available for specific outcomes of: early seizures or late seizures. Heterogeneity was measured with I2 statistic and sensitivity analysis was performed using pre-specified study characteristics. Results: 43 studies from 10,554 titles were identified; of which 37 studies reported incidence of post-stroke seizures and 6 studies reported effects of specific AEDs. Of 36,207 patients studied, 1,031 and 1,112 patients reported to have early seizures or late seizures, respectively. Most studies were of low to moderate quality. Rate of early seizures was 3.3% (95% confidence interval, 2.8% to 3.9%, I2 = 92.8%) while the incidence of late seizures or epilepsy was 18 per 1000-person-years (95% confidence interval, 15 to 22, I2 = 94.1%). The heterogeneity could not be explained despite various sensitivity analyses. For management of post-stroke seizures, no single AED was found to be effective over others, though newer AEDs were associated with lower risk of side effects Conclusions: The burden of post-stroke seizures and epilepsy is substantial. Further studies are required to determine risk factors for epilepsy following ischemic stroke and secondary prevention Funding: None