In this retrospective study, we explored the clinical and
stroke characteristics of patients treated with thrombolysis and/or mechanical
thrombectomy for an
acute stroke and experiencing early poststroke
seizures within 7 days of the
cerebrovascular accident. Patients with prior
epilepsy, primary
intracerebral hemorrhage or
transient ischemic attacks, or taking
antiepileptic drugs were excluded. We retrospectively identified 32 patients admitted between 2010 and 2016 (mean age 75 years; range: 49-90; 14 females and 18 males). A cortical
stroke was found in more than 70% of patients. Most epileptic
seizures were focal aware (46.7%) or generalized convulsive (43.3%). The median time between
stroke onset and seizure occurrence was 2 days; in 75.9% of the cases,
seizures occurred within the first 3 days. This retrospective case series is the largest published so far providing details on clinical features of patients with early poststroke
seizures following different reperfusion
therapies, not only restricted to intravenous (i.v.) thrombolysis. Early poststroke
seizures following reperfusion
therapies are associated with cortical
stroke involvement, are usually focal without impairment of awareness or generalized convulsive, and occur mostly within the first 3 days. Further studies are needed to clarify whether the low prevalence of focal impaired awareness
seizures (and nonconvulsive
seizures/status) is real or reflects the failure to recognize and correctly diagnose this seizure type in the acute poststroke period (risk of underascertainment due to the lack of systematic video-electroencephalogram (EEG) recording in patients with
stroke and difficulties in recognizing these
seizures). This article is part of the Special Issue "
Seizures &
Stroke".