A Retrospective Observational Study of Post-stroke Seizures from a Tertiary Care Hospital in India
Akshit Bararia1, Jitendra Upadhyay1, Amit Agarwal1, Deepak Yadav1, NAMAN SAHU1, Sanjay Pandey1
1Neurology and Stroke Medicine, Amrita Institute of Medical Sciences
Objective:

A retrospective observational study reporting patients with post-stroke seizures from a tertiary care teaching institute in India.

Background:

Stroke is a major cause of seizures in elderly patients; however there is a lack of sufficient data from our country. Post-stroke seizures may require life long treatment causing a significant burden of care in patients residing in third world countries.

Design/Methods:
In this retrospective analysis, we reviewed 300 patients who were admitted under our care between August 2022 and August 2025 with the diagnosis of 'seizure'. Of these, 35 patients were found to have stroke-related seizures. This identified cohort was categorized in three subgroups, based on the type of stroke: ischemic, hemorrhagic and both. Data for these 35 patients were compiled for baseline demographics, topography of lesions, semiology of seizure, electroencephalogram findings, and antiepileptic use.
Results:

In our cohort of 35 patients with stroke-related seizures, 10 were female (28.5%) and mean age was 68.7 ± 11.8 years. Out of 35 patients, 28 (80%) had ischemic lesions, 5 (14.2%) had hemorrhagic lesions and 2 patients (5.7%) had both. Patients with chronic infarcts were the major bulk of the cohort (57.1%) amongst which 9 (25.7%) had focal infarcts and 11 (31.4%) had multifocal lesions. 6 patients (17.1%) had acute ischemic stroke, all of them were multifocal. 2 patients (5.7%) had both acute and chronic infarcts. 5 (14.2%) patients had chronic hemorrhage out of which, 3 had focal lesions (8.5%) and 2 had multifocal involvement. Cortical involvement predominated in our study with most patients having lesions in parietal (51.4%) and occipital (40%) lobes, followed by frontal (28.5%) and temporal (25.7%) cortices. Subcortical and infratentorial structures were involved in <20% of the patients. Left and bilateral lesions slightly outnumbered right only involvement.

Conclusions:

Ischemic, chronic, multifocal and cortical lesions were strongly associated with post stroke seizures in our cohort.

10.1212/WNL.0000000000215449
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