Frequency and factors associated with post-stroke seizures in a large multicenter study in West Africa
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of the Neurological Sciences
Abstract
Background: Post-stroke seizures (PSS) are associated with significant morbidity and mortality across the globe.
There is a paucity of data on PSS in Africa.
Purpose: To assess the frequency and factors associated with PSS by stroke types across 15 hospitals in Nigeria
and Ghana.
Methods: We analyzed data on all stroke cases recruited into the Stroke Investigative Research and Educational
Network (SIREN). We included adults aged ≥18 years with radiologically confirmed ischemic stroke (IS) or
intracerebral hemorrhage (ICH). PSS were defined as acute symptomatic seizures occurring at stroke onset and/
or during acute hospitalization up until discharge. We used logistic regression to estimate adjusted odds ratios
(aOR) with 95% Confidence Interval.
Results: Among 3344 stroke patients, 499 (14.9%) had PSS (95% CI: 13.7–16.2%). The mean duration of
admission in days for those with PSS vs no PSS was 17.4 ± 28.6 vs 15.9 ± 24.7, p = 0.72. There were 294(14.1%)
PSS among 2091 ischemic strokes and 159(17.7%) among 897 with ICH, p = 0.01. The factors associated with
PSS occurrence were age < 50 years, aOR of 1.59 (1.08–2.33), National Institute of Health Stroke Score (NIHSS),
1.29 (1.16–1.42) for each 5 units rise and white cell count 1.07 (1.01–1.13) for each 10^3 mm3 rise. Factors
associated with PSS in ischemic were NIHSS score, aOR of 1.17 (1.04–1.31) and infarct volume of 10–30 cm3
aOR of 2.17(1.37–3.45). Among ICH, associated factors were alcohol use 5.91 (2.11–16.55) and lobar bleeds
2.22 (1.03–4.82).
Conclusion: The burden of PSS among this sample of west Africans is substantial and may contribute to poor
outcomes of stroke in this region. Further longitudinal studies are required to understand the impact on
morbidity and mortality arising from PSS in Africa.
Description
Research Article
Keywords
Seizures, Epilepsy, Stroke types, Africa