Early post-acute stroke seizures: Clinical profile and outcome in a Nigerian stroke unit

Aim: To describe the basic clinico-demographic profile and outcome of Early Post-Acute Stroke Seizures (EPASS). Materials and Methods: Two-hundred and fifty one patients admitted within 24 h of onset of stroke symptoms into the stroke unit of a tertiary care hospital were followed up for convulsive seizure(s) within 7 days of admission and for disease outcome in 42 days. Stroke subtype was defined by cranial computed tomography and ictal phenomenon was as described by the stroke unit doctors. Stroke severity was by the Canadian Neurological Scale (CNS) and Glasgow Coma Scale (GCS). Seizures were characterized as partial, generalized, or status. Stroke outcome was defined as discharge from inpatient care to follow-up or still in care and all cause in-hospital death. Data was compared between the group with and without seizures. The effect of age, sex, blood sugar, GCS, CNS, and seizure type on stroke outcome and time to in-hospital death in EPASS was tested on logistic regression and Cox proportional hazard regression. Result: EPASS occurred in 9.96% of subjects and intracerebral infarct was more associated with EPASS, a finding different from what is dominant in western literature. Conclusion: Profile of EPASS may appear different in terms of stroke subtype in Sub-Saharan African populations. Larger prospective studies may clarify the position better.