Abstract
Objectives: To determine the incidence of acute symptomatic seizures and post-stroke epilepsy following ischemic stroke during the first 6 months, and to describe associated clinical and neuroimaging characteristics.
Methods: This prospective observational study included patients with acute ischemic stroke. Patients with a prior history of epilepsy or underlying brain disorders associated with an increased seizure risk were excluded. Acute symptomatic seizures were defined as seizures occurring within 7 days of stroke onset, while post-stroke epilepsy was defined as unprovoked seizures occurring beyond 7 days. Clinical, neuroimaging, and treatment-related data were collected and analyzed using descriptive statistics.
Results: Among 250 patients, 5 (2.0%) developed acute symptomatic seizures and 3 (1.2%) developed post-stroke epilepsy within 6 months. Acute symptomatic seizures occurred early, with most cases presenting at stroke onset. All cases of post-stroke epilepsy developed within the first 3 months. Patients with post-stroke seizures commonly had severe stroke, cortical involvement, and infarction in the middle cerebral artery territory.
Conclusions: Post-stroke seizures were uncommon within the first 6 months after ischemic stroke, but were consistently associated with cortical infarction and middle cerebral artery involvement. Close monitoring during the acute and early post-stroke periods is essential, particularly in high-risk patients. Larger studies are needed to further clarify seizure risk and outcomes.
