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Abstract
Objective: To determine the influence of poststroke epilepsy on long-term functional outcome in young stroke survivors.
Methods: This study is a prospective cohort study among 537 stroke survivors with a first-ever TIA, ischemic stroke, or intracerebral hemorrhagic (ICH) stroke, aged 18 to 50 years. After a mean follow-up of 9.8 years (SD 8.4), we performed a follow-up assessment that included an evaluation for poststroke epilepsy and functional outcome. Odds ratios for poor outcome on the modified Rankin Scale (mRS) (score >2) and Instrumental Activities of Daily Living (IADL) (score <8) were calculated using logistic regression analysis.
Results: Forty patients (12.7%) with ischemic stroke, 4 patients (2.2%) with TIA, and 10 patients (25.6%) with ICH developed poststroke epilepsy. Ischemic stroke patients with epilepsy more often had a poor functional outcome than those without, both on the mRS and IADL (mRS score >2: 27.5% vs 9.8%, p = 0.001; IADL <8: 27.8% vs 12.6%, p = 0.02). Epilepsy was not related to functional outcome in patients with TIA and ICH. Multiple regression analysis revealed that epilepsy was an independent predictor of poor functional outcome after ischemic stroke assessed by mRS (mRS score >2: odds ratio 3.38, 95% confidence interval 1.33–8.60). In contrast, there was no such relation for IADL.
Conclusions: Epilepsy after stroke in young patients is a common problem that negatively affects functional outcome, even more than 10 years after ischemic stroke.
GLOSSARY
- AED=
- antiepileptic drug;
- CI=
- confidence interval;
- FUTURE=
- Follow-Up of TIA and stroke patients and Unelucidated Risk factor Evaluation;
- IADL=
- Instrumental Activities of Daily Living;
- ICH=
- intracerebral hemorrhage;
- mRS=
- modified Rankin Scale;
- OR=
- odds ratio
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received May 24, 2013.
- Accepted in final form August 26, 2013.
- © 2013 American Academy of Neurology
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