STROKE - RISK OF SEIZURE

Citation: Burn J, Dennis M, Bamford J et al. Epileptic seizures after a first stroke: the Oxfordshire community stroke project. BMJ 1997;315:1582-7.

Three-part Question: In a patient with stroke, what is the risk of seizure at one year?
Search Terms: "stroke" and "seizure" in Medline

The Study:
675 pts registered in a community-based stroke registry after their first stroke
The Outcome: seizure

The Evidence:

Well-defined sample at uniform (early) stage of illness..?	yes
Follow-up long enough..?	yes;
Follow-up complete..?	yes;
Blind and objective outcome criteria..?	no;
Adjustment for other prognostic factors..?	no;
Validation in an independent "test-set" of patients..?	no

Prognostic Factor	Outcome	Time	Measure	Confidence Interval
cerebral infarction	seizure	1 year	4.2%	2.2 to 6.2
primary intracerebral haemorrhage	seizure	1 year	19.9%	1.5 to 38.3
subarachnoid haemorrhage	seizure	1 year	22%	2.6 to 41.8
any stroke	seizure	1 year	5.7%	3.5 to 7.9

Comments:

1. unsure how physicians selected patients for registration
2. onset seizures (those occurring within 24 hrs of onset of stroke) associated with increased risk of seizure - OR 7.52 (2.46 to 22.98)
3. probability of post-stroke seizure higher among patients >84 (but numbers small)

Appraised by: Straus, March 1998;
Expiry date: 1999

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