Etedal Ahmed Abu Elbasher Ibrahim1,2* and Saida Musa Alshiekh Ahmed1
1The National Centre for Neurological Science, Sudan
2Al-Neelain University, Sudan
Background: Post‐stroke seizure and post‐stroke epilepsy are common causes of hospital admissions, either as a presenting feature or as a complication after a stroke. They require appropriate management and support in long term.
Objective: To measure the frequency, predictive factors and prevalence of post stroke epilepsy among adults in Khartoum state, Sudan, 2018.
Methods: A prospective multicentre study conducted at four teaching hospitals located in Khartoum state as following; the National Centre for Neurological Science, Omdurman teaching hospital, Khartoum North Teaching Hospital and National Ribat Teaching Hospital. This study covered 140 study participants recruited from the study area within one year duration. Who have seizure with or after stroke came to hospital as a first presentation or for follow up, Data collected through structural closed ended questionnaire and checklist. Data entered, cleaned, analyzed using SPSS version 25.0.
Results: There is almost equal gender ratio male: female 1:1, 69.3% of them were above 60 years of age, 30 (46.9%) were males and 34 (53.1%) were females. Out of 64 patients with post stroke epilepsy, 41 (64.1%) were more than 60 years, 17 (26.6%) were 30 to 60 years and 6 (9.4%) of them were 16 to 30 years. Regarding risk factors, 42 (65.6%) had hypertension, 35 (54.7%) diabetes, 3 (4.7%) were smoker, 4 (6.3%) hypercholesterolemia, 6 (9.4%) had CHD and 5 (7.8%) had Atrial fibrillation. The most frequent types of seizures were generalized tonic clonic 54.7%, simple partial 10.9% then focal with secondary generalization 17.2%, 95.4% of them had power less than G4. Brain MRI & MRA Showed parietal lobe affection in 37.5%, frontal lobe in 12.5% and multiple lobar affection was found in 17.5%. Only 1.4% had poly spikes waves in EEG, 21.5% had atrial fibrillation in ECG, 26.4% had cardiac thrombus, 9.3% had valve disease in Echocardiography, and 20.7% had blood glucose more than 200 mg/dl. high potassium was found in 3.6%, low sodium in 2.9%, low calcium in 5%, low magnesium 3.6%, high urea in 16.4% and high creatinine in 15%. 20% of the study participants had intracranial hemorrhage, 80% had ischemic stroke. There is a significant association between them (p value =0.0029), it is noticed that being diagnosed as hemorrhagic stroke considered as main predictive factors for the future occurrence of Post stroke seizures. The prevalence of post stroke seizures among the study participants was 45.7%.
Conclusion: The study found that there is a significant association between post stroke seizures and hemorrhagic stroke (p value =0.0029). Hemorrhagic stroke considered as a main predictive factors for the future occurrence of Post stroke seizures. Hypertension followed by Diabetes was the main risk factors followed by cardiac thrombus and atrial fibrillation. Generalized seizures were common. The parietal lobe was the most affected lobe. The prevalence of post stroke epilepsy was 45.7%.
Epilepsy; Post stroke; Prevalence; Predictive factors
Elbasher Ibrahim EAA, Alshiekh Ahmed SM. Post Stroke Epilepsy, The Frequency, Predictive Factors and Prevalence in Sudanese Patients, A Prospective Multicentre Study Khartoum, Sudan 2018. Neurol Disord Stroke Int. 2019; 2(1): 1015.