European Journal of Cardiovascular Medicine

Background: Post-stroke seizures are a notable complication of cerebrovascular events, particularly in elderly patients, with significant impact on prognosis and quality of life. This study aims to analyze the characteristics and patterns of post-stroke seizures, examining associations with demographic factors, lesion characteristics, stroke classification, and stroke severity. Aim: To assess the demographic and clinical characteristics of post-stroke seizures, examining associations with stroke subtypes, lesion location, seizure types, and stroke severity as per NIHSS and Oxfordshire classifications. Material and Methods: This prospective, cross-sectional study was conducted at the Neurology Department, St. Stephen’s Hospital, Delhi, over a period of 19 months. Sixty patients presenting with a first episode of post-stroke seizure were included. Inclusion criteria were based on clinical findings, neuroimaging (MRI or CT), and EEG. Data were analyzed using descriptive statistics, and correlations were assessed using Chi-square tests. Results: Among the study cohort, 62% were male, with a mean age of 65.8 years; 81% were over 50 years. Focal seizures were more common (56.6%) than generalized seizures (38.4%), with immediate onset seizures occurring in 55% of cases. Cortical lesions were more associated with seizures (65%) than subcortical lesions (11.6%), particularly in the left hemisphere (55%). PACI was the most common ischemic stroke type (64%) associated with seizures, while larger volume ICH presented greater risk in hemorrhagic stroke. Significant associations were found between NIHSS severity and stroke subtype (p = 0.0001), as well as with Oxfordshire classification (p = 0.00001). Conclusion: Post-stroke seizures exhibit distinct demographic and clinical patterns, with focal seizures predominating in cortical and left-sided lesions. PACI and cardio-embolic strokes were linked to higher seizure risk. Stroke severity as measured by NIHSS and Oxfordshire classification were significantly associated with seizure onset, underscoring the importance of targeted monitoring in high-risk groups.