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Abstract
Objective: To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke.
Methods: Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors.
Results: A total of 714 patients (315 women, 399 men; age 27–97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5–14.9) followed by CIHT (OR 2.7; 95% CI 0.8–9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8–20.8) and for CI (OR 3.1; 95% CI 1.3–7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03–0.8) was a protective factor for IPH.
Conclusion: The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke.
Footnotes
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Study funding: Supported by Regione Emilia-Romagna, Progetto Strategico “Stroke Care.”
-
Editorial, page 1776
-
See page 1794
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Supplemental data at www.neurology.org
-
- CI=
- confidence interval;
- CIHT=
- cerebral infarction with hemorrhagic transformation;
- mRS=
- modified Rankin Scale;
- NIHSS=
- NIH Stroke Scale;
- OR=
- odds ratio;
- PIH=
- primary intracerebral hemorrhage;
- TIA=
- transient ischemic attack
- Received September 14, 2010.
- Accepted April 5, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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