Background/Aims: Post stroke epilepsy (PSE) is a serious complication of stroke. There is limited data on PSE from South Asia, and no published data is available from Sri Lanka. We aimed to evaluate the prevalence and characteristics of PSE in patients attending a Sri Lankan stroke clinic.
Methods: Data of a prospective cohort of stroke patients attending the stroke clinic of a tertiary care centre over a one-year period (October 2022- September 2023) were analysed. PSE was defined as seizures developing after 7 days of stroke onset. Data on demographic features, stroke characteristics, treatment and functional outcomes were analysed.
Results: Out of 332 patients followed up, 13 (3.9%) had PSE [84.6%% males; median age (SD) 55 years (9.3)]. Of them, majority had ischaemic (84.6%) and cortical (92.3%) strokes. Main aetiological factor was cardioembolism (53.8%) in ischaemic strokes, and 23.1% had received intravenous thrombolysis. Eleven patients (84.6%) had moderate-severe strokes (NIHSS>4), and majority had severe disability on discharge (mRS 3-5-84.6%; BI <60 – 69.2%).
Majority (76.9%) had the first seizure >12 months after stroke onset. One patient had acute symptomatic seizures during acute stroke period. Majority (61.5%) had only a single seizure. Eleven patients (84.6%) were currently on anti-seizure medications (ASMs), and eight (61.5%) were managed with one ASM.
Conclusion: Prevalence of PSE in our study was similar to published data. Majority had ischaemic strokes, cortical involvement, severe strokes and severe disability after stroke. Majority were on ASMs and had only a single seizure following stroke.