Abstracts

Stroke-related seizures are frequently defined as early (within 2 weeks after stroke) and late. The incidence of early and late seizures is relatively well established. The incidence of acute seizures ([le]24 hours after stroke) is unknown. In this population-based study, we aimed to establish the incidence of acute post-stroke seizures in a biracial cohort. We also sought to determine if there were any differences between race, stroke subtype, and stroke localization., All stroke cases between 7/93-6/94 within the population of the Greater Cincinnati metropolitan region were identified by review of all primary and secondary stroke diagnoses (ICD-9 codes 430-436) from 19 local acute-care hospitals, outpatient clinics, autopsy cases, and death certificates. Clinical and demographic data was collected by study nurses and subsequently reviewed by study physicians. The presence of seizures in the 24 hours after stroke symptom onset was obtained through additional record review; patients with a prior history of seizure were excluded. All available neuroimaging performed at the time of stroke was reviewed by study physicians., We identified 2932 strokes who had no prior history of seizures, of which 122 (4.2%) had seizures within the first 24 hours of stroke onset. Of ICH/SAH patients, 11.4% had a seizure within the first 24 hours of stroke onset (p[le]0.0001 vs. all stroke). In ischemic stroke, we observed a trend towards seizures being more common with cardioembolic stroke vs. all other ischemic stroke subtypes (4.5% vs. 2.9%, p=0.07). There was a higher mortality rate in patients who developed stroke-related acute seizures. See table for additional detail., The overall rate of epileptic seizures within the first 24 hours of stroke onset is 4.2%. Risk factors for developing seizure activity include younger age, lower initial GCS score, and hemorrhagic stroke (ICH/SAH). Patients with stroke-related acute seizures have a higher 30-day mortality than patients without seizures. This may be related to a higher incidence of hemorrhagic stroke in this group.[table1],