Background: Seizures are a life-threatening complication of acute stroke. There is limited data on seizures after stroke from South Asian countries, and no published data are available from Sri Lanka. We aimed to assess the prevalence and characteristics of acute symptomatic seizures (ASS) after stroke in a Sri Lankan stroke unit.
Methodology: Data from a prospective cohort of stroke patients admitted to the Stroke Unit of a Sri Lankan tertiary care centre over a period of four-and-a-half years (July 2019 to December 2023) were analysed. Data on patient characteristics, stroke characteristics, clinical manifestations, diagnosis, treatment and clinical outcomes were recorded. Descriptive analysis of data was performed.
Results: Out of 690 admissions to the stroke unit, 17 (2.46%) had ASS. Ten patients (58.8%) were male; mean age (SD) 65 years (10.6), age <65y 8(47.1%). Eleven (64.7%) had ischaemic strokes, 12 (70.6%) were cortical, nine (52.9% were right sided. Mean (SD) NIHSS score on admission was 15.2 (6.6). Functional dependence was common at discharge [mRS 3-5 16(94.1%), BI <60 14(82.4)].
Three patients (17.6%) presented with seizures as the first clinical symptom of stroke. Ten patients (10.8%) had multiple seizure episodes; one (5.9%) had status epilepticus. Sixteen patients (94.1%) received anti-seizure medications (ASMs); twelve (70.6%) were given multiple ASMs.
Conclusions: Prevalence of ASS in our study was similar to published data. Most patients had ischaemic strokes and cortical involvement. Majority were treated with multiple ASMs. Functional outcomes were poor in patients with ASS.