ABSTRACT Background Stroke is a leading cause of epilepsy in older adults. However, the specific roles of stroke severity, chronic ischemia and microangiopathy in the development of post stroke epilepsy (PSE) remain unclear. Objectives This study aimed to investigate potential predictors for the development of PSE, with a particular focus on stroke severity and neuroimaging findings. Method We analyzed 129 patients with ischemic stroke (IS), comprising 30 patients with PSE and 99 without PSE (non‐PSE). PSE was defined as unprovoked seizure occurring after 7 days from stroke onset. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at admission and discharge, while functional outcome was assessed using the modified Rankin Scale (mRS). Neuroimaging was reevaluated to assess cerebral microangiopathy using the Fazekas scale, medial temporal atrophy (MTA) and global cortical atrophy (GCA) to assess the extent of cerebral microangiopathy. Result Patients with PSE exhibited significantly higher NIHSS scores both at admission and discharge compared to non‐PSE ( p < 0.01). Similarly, discharge mRS scores were significantly higher in the PSE than the non‐PSE group ( p < 0.01). The frequency of acute symptomatic seizures was significantly higher in the PSE group than the non‐PSE group ( p < 0.003). Logistic regression analysis identified higher mRS levels at discharge and alcohol overconsumption as significant predictors for PSE. Increasing mRS scores were associated with a progressively higher odds ratio for developing PSE ( p < 0.001). Neuroimaging including the Fazekas scale, MTA and GCA showed no significant association with PSE. Conclusion Predictors for PSE include clinical severity (NIHSS) and functional disability (mRS), acute symptomatic seizures, alcohol overconsumption and anticoagulant therapy. With discharge mRS emerging as the most significant predictor. No association was found between MRI markers of cerebral microangiopathy and development of PSE.
Rashid et al. (Thu,) studied this question.