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Seizures more common after haemorrhagic stroke than ischemic stroke

27 November, 2000

According to findings published in the November issue of the Archives of Neurology, patients who have had a hemorrhagic stroke are more likely to have a poststroke seizure compared with patients who have had an ischemic stroke.

Dr. Christopher F. Bladin, from Box Hill Hospital, Melbourne, Australia, and the International Seizures After Stroke Study Group collected data on 1,897 patients with acute stroke, who had no history of epilepsy and for whom computed tomographic diagnosis was available.

During a follow-up of 9 months, 168 patients had one or more seizures, according to the report. In total, 28 of the 265 patients (10.6 per cent) who had experienced hemorrhagic strokes had one or more seizures, as did 140 of the 1,632 patients (8.6 per cent) who had experienced ischemic strokes. A Kaplan-Meier survival analysis showed that those with hemorrhagic strokes were at a 2-fold increased risk of seizure compared with those who had ischemic stroke.

Dr. Bladin's group notes that 47 patients from the cohort had recurrent seizures (epilepsy). After ischemic strokes, the researchers say, a late onset of seizure was an independent risk factor for epilepsy; however, this was not the case after hemorrhagic strokes.

The research team speculates that "a combination of the sudden development of space-occupying lesion with mass effect, focal ischemia, and blood products might possibly account for seizures in the early phase of hemorrhagic stroke."