Status epilepticus in stroke: report on a hospital-based stroke cohort.

OBJECTIVE

To evaluate occurrence rate, clinical data, and prognostic factors of status epilepticus (SE) after stroke.

METHODS

From 1984 to 1994, 3,205 patients were admitted to the Department of Neurology at our institution with first-time strokes. A total of 159 of these patients had first-time poststroke seizures. Among these 159 patients, cases of SE were identified and evaluated.

RESULTS

SE was recognized in 31 patients (19%). In 17 patients, SE was the first epileptic symptom (initial SE), and in 4 patients, stroke began with SE (S-SE). In the 14 remaining patients, SE occurred after one or more seizure(s). After a mean follow-up period of 47 months, neurologic deterioration occurred after SE in 15 patients. This deterioration was permanent in two patients. Fifteen patients died; in five patients, death was directly related to SE. Eight of the 17 patients with initial SE and all 14 patients with SE after one or more seizure(s) developed other seizures or SE. S-SE, however, was not a predictive factor for additional seizure(s).

CONCLUSIONS

Status epilepticus is common among patients with poststroke seizures. Although the immediate prognosis of patients with status epilepticus is poor, status epilepticus as the presenting sign did not necessarily predict subsequent epilepsy.