The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study

Objective Epileptic seizures are a common complication after stroke. The relation between occurrence of seizures after stroke and long-term mortality remains elusive. We aimed to assess whether seizures in an early or late phase after ischemic stroke are an independent determinant of long-term morta...

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Bibliographic Details
Published in:Journal of neurology 2018-08, Vol.265 (8), p.1780-1788
Main Authors: van Tuijl, J. H., van Raak, E. P. M., van Oostenbrugge, R. J., Aldenkamp, A. P., Rouhl, R. P. W.
Format: Article
Language:English
Subjects:
Age
Epilepsy
Ischemia
Medicine
Medicine & Public Health
Mortality
Neurology
Neuroradiology
Neurosciences
Original Communication
Risk factors
Seizures
Stroke
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Summary:Objective Epileptic seizures are a common complication after stroke. The relation between occurrence of seizures after stroke and long-term mortality remains elusive. We aimed to assess whether seizures in an early or late phase after ischemic stroke are an independent determinant of long-term mortality. Methods We prospectively included and followed 444 ischemic stroke patients with a first-ever supratentorial brain infarct for at least 2 years after their stroke regarding the occurrence of seizures. The final follow-up for mortality is from April 2015 (follow-up duration 24.5–27.8 years, mean 26.0 years, SD 0.9 years). We compared patients with early-onset seizures with all seizure-free patients, whereas the patients with late-onset seizures were compared with the 1-week survivors without any seizures. We used Cox-regression analyses to correct for possible confounding factors. Results Kaplan–Meier analysis showed significantly higher mortality for the patients with early-onset seizures ( p  = 0.002) but after correction for known risk factors for (long term) mortality early-onset seizures had no independent influence on long-term mortality (HR 1.09; 95% CI 0.64–1.85). In patients with late-onset seizures, no significant influence from late-onset seizures on long-term mortality was found (univariate p  = 0.717; multivariate HR 0.81; 95% CI 0.54–1.20). Conclusion Both early-onset and late-onset seizures do not influence long-term mortality after ischemic stroke.
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-018-8907-7