AN OBSERVATIONAL STUDY ON CLINICAL AND RADIOLOGICAL PROFILE OF POST-STROKE SEIZURES PATIENTS

*Dr. P. Sankara Narayanan MD DM

ABSTRACT

Aims: To evaluate the incidence of early versus late post stroke seizures, and its type as well as its relation with different type of stroke and location of the involvement and correlation with different risk factors along with to know occurrence early versus late post stroke seizures in young versus old stroke patients. Methodology: All the patients with the diagnosis of post-stroke seizures were included. Those with known epilepsy, sepsis, electrolyte imbalance, patient having old stroke presenting with fresh stroke and any other reversible precipitating factors were excluded. Data collected regarding the age, co-morbid conditions, details of seizures and radiological findings including type and location of stroke. Results: Total of 150 subjects with post-stroke seizures were included. 61% were males while 39% were females. Mean age of the study population was 53.2 ± 12 years. 22 patients had young stroke ( 45 years. Early post-stroke seizures were seen in 51% of patients. Rest of the patients i.e. 49%, had late-seizures. GTCS were the most common type of seizures seen in 65% patients, followed by partial motor with secondary generalization and partial motor seen in 25% and 10% of the patients respectively. 69% of the patients had multiple episodes of seizures i.e. two or more than two episodes while 31% had only single episode of seizure. Only 3% had status epilepticus. 82% of the patient had Ischemic stroke while hemorrhagic stroke was seen in 18% of the patients. Also 65% of the patient had cortical location of stroke while 35% had subcortical location. Comparison between early and late onset seizures revealed significant association between ischemic heart disease (IHD) and hypertension with late onset seizures (p < 0.05). Conclusion: Post-stroke seizures were more frequent in male population, elder people with comorbid illness like hypertension, and with cortical ischemic strokes. Early seizures, multiple episodes and generalized tonic clonic seizure type were more common. History of ischemic heart disease and hypertension showed a strong relationship with the occurrence of late onset seizures. Long term prospective studies are essential to identify whether control of hypertension and IHD may lead to fall in incidence of post stroke seizures.

Keywords: Seizures, Stroke, Early versus Late Post stroke seizures.