This study found that there was no statistically significant difference in age and sex between cases and controls. In agreement with a study did not find age differences in patients with and without seizures . This result may be explained by the small sample size. In contrast to a study determined that having stroke younger than 65 years was an important risk factor for seizure occurrence .
This study was in agreement with a study found that, both genders have the same risk of post stroke seizures . In contrast to a study found that, post-stroke seizures were more common in male patients than females . Another study found that the female gender is associated with a higher risk of early seizures after stroke .
This study found that there was no statistically significant difference between the three groups as regard history of diabetes mellitus, hypertension, heart diseases, atrial fibrillation, carotid stenosis and collagen diseases. In agreement with a study found that the above factors have no obvious relationship with the occurrence of early seizures . In contrast to a study showed that there is a high correlation between hypertension, diabetes mellitus, heart diseases and the occurrence of early seizures .
This study found that 43.33% of the patients developed focal to bilateral tonic clonic seizures, 33.33% developed focal aware seizures, 16.67% of the patients developed generalized tonic clonic seizures and 6.67% of the patient developed status epilepticus. The same as a study found that 72% of PSS were focal onset seizures, among them 22% with evolution on bilateral convulsion. 28% of PSS were generalized onset seizures . In contrast to a study which documented that seizures were more often generalized than partial .
This study found that, the brain imaging of the cases group who developed seizures showed that, 50% of the cases have arterial ischemic infarction, 30% venous infarction, 6.67% ischemic infarction with haemorrhagic transformation, 6.67% intracerebral haemorrhage and 6.67% have subarachnoid haemorrhage. These results are consistent with a study which state that, the prevalence of seizures after ischemic stroke is higher than hemorrhagic stroke. The etiology of stroke due to infarction is significantly more prevalent than bleeding, so that the main incidence of seizures is related to the cerebral vascular occlusive disease . In contrast to a study revealed a higher incidence of seizures in patients with hemorrhagic stroke than ischemic stroke . Another study conducted in Indonesia, did not find a correlation between the incidence of early seizures and the type of stroke .
This study was in agreement with the study by Copenhagen stroke, they did not find a significant relationship between cortical involvement and early onset seizures . In contrast to studies which state that the prevalence of seizures in cortical lesions is higher than in subcortical Lesions. Cortical involvement is a risk factor for the development of seizures in ischemic stroke and hemorrhagic stroke . Cortical irritation is thought to be the cause of the higher epileptogenicity of stroke.
The incidence of seizures was higher for the patients with PACS (33.33%), than TACS (13.33%), PCS (10%) and lacunar syndrome (0%). However, there was no statistically significant difference between the three groups. The same as study that observed that TACS was not significantly associated with an increased post-stroke seizure risk, probably because the area affected by stroke is too large for the surviving neurons to get excited or carry epileptiform activity from the area of gliosis . Strokes in anterior vascular territories are more likely to cause seizures compared to posterior ones attributed to the fact that the anterior vascular territory involves larger areas of the cortex .
Most EEG findings in this study were focal slowing, focal epileptiform activities, generalized epileptiform activities and PLEDS. The same as the study found that, focal or diffuse slowing was found in 84% of them and lateralized periodic discharges, which are related to interictal epileptiform abnormalities, in 6% . In addition, a study found that, diffuse slowing of background activity was the most common (67/232, 28.9%). Focal slowing and epileptiform activity were noted in 50/232 (21.5%) and 115/232 (49.6%), respectively. periodic lateralized epileptiform discharges (PLEDs) were found in 8 (7.0%) .
This study showed that there was no significant relationship between seizures and early treatment with Rtpa and thrombectomy. A study also, could not find association between treatment modality and occurrence of seizures . However, systemic thrombolysis was a significant predictor of early seizures in two studies including a multicenter trial .
This study found that, there was no statistically significant difference between the three groups as regard the functional outcome. The same as a study found that the acute clinical epileptic seizure does not appear to be an independent predictor of the unfavorable outcome at hospital discharge . In contrast to a study found that early seizures after stroke was associated with poorer functional outcome at hospital discharge .
The study had some limitations as the small sample size, which may limit the strength of the results. This is hospital—tertiary health care center-based study, limiting generalization of the findings of the study.