Predictors of seizures in patients with stroke in a tertiary care setup

Abstract

Objective: To determine clinical and imaging predictors of post-stroke seizures among adult patients admitted with stroke.

Method: The prospective, observational study was conducted from April 2023 to March 2024 at Aga Khan University Hospital, Karachi, and comprised patients aged 18-85 years who were admitted with a diagnosis of stroke. Demographic variables, comorbid conditions, stroke characteristics, and neurological severity scores, as assessed with Glasgow Coma Scale and National Institutes of Health Stroke Scale, were recorded. The relationship between these factors and post-stroke seizures was explored. Data was analysed using SPSS 24.

Results: Of the 111 patients with mean age 63+/-16 years, 68(61.3%) were male. Post-stroke seizures were observed in 38(34.2%) of the participants. Stroke location (p=0.043), Glasgow Coma Scale score <12 (p<0.001), and National Institutes of Health Stroke Scale score (p<0.001) were significantly associated with seizure occurrence. Mortality and prolonged hospital stays were also higher among patients who developed seizures (p<0.05). No significant association were found for seizure occurrence with demographic factors, comorbidities and prior stroke history (p>0.05).

Conclusion: Stroke severity and brain region involvement, particularly temporal lobe lesions, were found to be significant predictors of post-stroke seizures.

Key Words: Seizures, Stroke, Temporal lobe, Consciousness disorders, Glasgow Coma Scale.