The Incidence Rate of Post-Stroke Epilepsy: A Multi-Center, Retrospective Study in Taif City

Background: The International League Against Epilepsy in 2014, defined epilepsy in any patient who has experienced one unprovoked seizure and has a probability of further seizures similar to the general recurrence risk (at least 60%) after 2 unprovoked seizures occurring over the next 10 years. Epilepsy patients are classified into 2 groups: early post-stroke seizures (EPSS), including patients who experience a seizure within 1 week of stroke onset, and late PSS (LPSS), including those who have a seizure more than 1 week after the stroke. Methods: This retrospective, record-based study was conducted between January 2021 and December 2024. A total of 486 stroke patients were screened. After excluding 241 patients with prior brain tumors, surgeries, or stroke events, 245 patients were included. Data were collected using a structured checklist covering demographic characteristics, seizure risk factors, stroke type and mechanism, seizure type, and timing of PSE diagnosis. Statistical analyses were performed using SPSS. Chi-square tests and logistic regression were used to evaluate the associations between risk factors and PSE development. Results: Of the 245 patients, 17 (6.9%) developed PSE. Among them, 41.2% were classified as having EPSS and 58.8% as having LPSE. Most PSE patients were men and married. Most seizures were of an unknown type. A statistically significant association was found between the mechanism of stroke and the development of PSE (p = 0.021), particularly cardioembolic and atherosclerotic (thrombotic) stroke. Other variables including age, sex, ICU admission, and comorbidities did not show statistically significant associations. Conclusion: The incidence of PSS in this study was 6.9%. LPSS was more common than EPSS. The development of PSE was significantly associated with stroke mechanisms, particularly cardioembolic and thrombotic stroke, whereas other risk factors showed no significant relationship.