FREQUENCY OF POST-STROKE SEIZURES IN LOCAL POPULATION OF PAKISTAN

Abstract

Background: Post-stroke seizures (PSS) are a common neurological complication following cerebrovascular accidents and are associated with increased morbidity and mortality. The incidence of PSS varies globally due to differences in stroke subtypes, patient demographics, and diagnostic methods. Limited data are available from Pakistan regarding the frequency and characteristics of PSS. Objective: To determine the frequency of post-stroke seizures among patients admitted with stroke in a tertiary care hospital in Pakistan. Methods: This descriptive case series was conducted at the Department of Neurology, National Hospital and Medical Center, Lahore, over a period of six months from September 2024 to February 2025. A total of 67 stroke patients aged 18–70 years were included using non-probability consecutive sampling. Patients with a known history of epilepsy or metabolic abnormalities (sepsis, electrolyte imbalance) were excluded. Stroke diagnosis was confirmed by CT scan. The occurrence, timing (early/late), and type (generalized/partial) of seizures were recorded. Data were analyzed using SPSS version 27. Descriptive statistics were applied, and Chi-square tests were used for associations (p ≤ 0.05 considered significant). Results: Among 67 patients, 40 (59.7%) were males and 27 (40.3%) females. The mean age was 58.3 ± 10.2 years. Ischemic stroke accounted for 44 (65.7%) cases, hemorrhagic stroke for 18 (26.9%), and venous infarcts for 5 (7.4%). Post-stroke seizures occurred in 13 (19.4%) patients. Early seizures (within 7 days) were seen in 9 (13.4%) cases, while late seizures occurred in 4 (6.0%). Seizures were more frequent in hemorrhagic stroke (33.3%) compared to ischemic (13.6%) and venous infarcts (20%). Generalized seizures were observed in 10 (76.9%) cases, and partial seizures in 3 (23.1%). Conclusion: The frequency of post-stroke seizures in this local population was 19.4%, with higher prevalence in hemorrhagic stroke. Early seizures were more common than late seizures. These findings emphasize the need for vigilant monitoring and early seizure prophylaxis, particularly in patients with hemorrhagic or cortical strokes.