Post-Stroke Seizures and Epilepsy: Risk factors and Outcome.

Introduction: Cerebrovascular disease is considered to be the most common cause of epilepsy in the elderly. However, information pertaining to incidence of post-stroke seizures and epilepsy, factors influencing occurrence of seizures in patients with stroke, management and their influence on overcome are noted to be very variable in the literature, and not extensively explored. Aim: This study aims to explore the prevalence of seizures and epilepsy among patients with stroke, risk factors associated with their occurrence and their influence on outcome.Patients and methods: Adult patients with acute stroke ?either ischemic or hemorrhagic, occurring new or over the last three years will be recruited. Demographic data; type of stroke (based on TOAST classification); nature and severity of neurologic deficits (on NIH Stroke Scale); risk factors for stroke (including Hypertension, Diabetes mellitus, Hyperlipidemia, smoking, alcohol abuse); imaging observations including: location(s) of infarct or hemorrhage, presence of periventricular or cortical changes, microbleeds (on MRI imaging), mass effect; changes in electrolytes, renal and liver functions; evidence of intercurrent infection; - will be documented. Occurrence of seizures in the acute phase of stroke or later over a period of 1 year ? occurring spontaneously or in relation to systemic crises (eg.infection, electrolyte disorders, etc) will be noted. Occurrence of Epilepsy, defined as the occurrence of recurrent seizures will be documented, along with anticonvulsant medication used and their efficacy in control. Outcome at the end of 1 year of follow up will be recorded using modified Rankin Score (scale of 0-6). Quality of life will be documented using Stroke Specific Quality of Life scale. Analysis: Univariate and multivariate methods of analysis will be applied to explore factors associated with the post-stroke seizures/epilepsy, and outcome.