Higher Mortality Associated With Seizure Soon After Stroke

April 1, 2007

Patients who experience seizure 24 hours after stroke onset may be at increased risk for death, according to Angela Rackley, MD, a clinical neurophysiology fellow in epilepsy, and coresearchers at the University of Cincinnati. Rackley presented an abstract on the incidence of seizures within 24 hours after acute stroke at the annual meeting of the American Epilepsy Society in San Diego this past December. She and colleagues found a higher 30- day mortality rate among patients who had a seizure within hours of stroke compared with patients who did not experience poststroke seizure.

PATIENTS WHO EXPERIENCE SEIZURE 24 HOURS AFTERstroke onset may be at increased risk for death, accordingto Angela Rackley, MD, a clinical neurophysiologyfellow in epilepsy, and coresearchers atthe University of Cincinnati. Rackley presented anabstract on the incidence of seizures within 24 hoursafter acute stroke at the annual meeting of theAmerican Epilepsy Society in San Diego this pastDecember. She and colleagues found a higher 30-day mortality rate among patients who had aseizure within hours of stroke compared with patientswho did not experience poststroke seizure.

Researchers working on the retrospective population-based study identified 2932 stroke patientsthrough chart reviews at 19 local acute care hospitalsand outpatient clinics in the greater Cincinnatimetropolitan region as well as autopsy cases anddeath certificates. Patients with a past history ofstroke were excluded from the study.

Of the 2932 patients, 122 (4.2%) had seizureswithin the first 24 hours after stroke. Among patientswith ischemic stroke, the researchers observedthat seizures were more common in thosepatients who had had cardioembolic stroke versusall other ischemic stroke subtypes.

A higher mortality rate also was seen in patientswho experienced seizure after stroke: 28.7% versus12.8%. The higher 30-day mortality rate among patientswith seizures may have been associated withhemorrhagic stroke, the incidence rate of whichwas higher in this group: 32.0% versus 10.5%. Riskfactors for the development of seizure within 24hours after stroke included younger age; lower initialGlasgow Coma Score; and hemorrhagic stroke,such as intracerebral hemorrhage and subarachnoidhemorrhage.
-Myra Partridge