Occurrence and risk factors of unprovoked epileptic seizures in ischaemic stroke patients

Authors: P. Janský 1;  T. Růžičková 1;  ;  A. Olšerová 1;  J. Reichl 2;  M. S. Vosko 3;  L. Šťovíčková 1;  J. Paulasová-Schwabová 1;  V. Šulc 1;  H. Magerová 1;  A. Kalina 1;  D. Kala 4;  J. Otáhal 4;  P. Marusič 1;  M. R. Vosko 4;  A. Tomek
Authors‘ workplace: Department of Neurology, Second, Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic 1;  Department of Neurology 2, Kepler, Universitätsklinikum, Med Campus III, Linz, Austria 2;  Technical University of Munich, School of Medicine, Germany 3;  Institute of Physiology, Czech, Academy of Sciences, Prague, Czech, Republic 4
Published in: Cesk Slov Neurol N 2020; 83/116(3): 278-284
Category: Original Paper
doi: 10.14735/amcsnn2020278


Aim: The aim of our study was to determine the occurrence of unprovoked epileptic seizures in ischaemic stroke (IS) patients and compare their association with SeLECT score risk factors (IS severity, large-artery atherosclerosis, acute symptomatic epileptic seizures in association with the initial IS, cortical localization of the lesion, the involvement of the middle cerebral artery territory).

Patients and methods: Retrospective analysis of consecutive supratentorial IS survivors with a negative history of epilepsy, admitted to two major comprehensive stroke centers in the Czech Republic and Austria in one year period (2015). The follow-up information was collected from available medical documentation, using a structured telephone questionnaire and patients visits.

Results: 315 patients were included (59% men, median age 69 years, median National Institutes of Health Stroke Scale 4, intravenous thrombolysis 29.2%, mechanical thrombectomy 6.3%). Unprovoked epileptic seizures occurred in 24 patients (7.6%), the median follow-up period was 3.3 years. The seizure and seizure-free groups differed significantly in cortical involvement of the ischaemic lesion (70.8 vs. 38.5%; P = 0.002), a significant difference in the rest of SeLECT score risk factors was not found.

Conclusions: Unprovoked epileptic seizures occurred in 7.6% of IS survivors during the median follow-up period of 3.3 years. Cortical involvement of the ischaemic lesion was the only SeLECT score parameter with a significant difference between seizure and seizure-free groups.


ischaemic stroke – unprovoked seizure – post-stroke epilepsy – risk factor – incidence


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