POSTSTROKE LATE SEIZURES AND THEIR ROLE IN REHABILITATION OF INPATIENTS

Purpose: This study was designed to (a) identify the prevalence of pos tstroke late seizures in a population of patients admitted to rehabili tation of neurologic sequelae of their first stroke, (b) recognize rel iable prognostic factors associated with the occurrence of poststroke late seizures, and (c) evaluate the impact of seizures on the results of rehabilitation treatment. Methods. In a prospective study of 306 co nsecutive patients admitted to a rehabilitation hospital for sequelae of their first stroke, we assessed the relation among 15 independent v ariables and the development of seizures by using multiple regression analysis (forward stepwise). In addition, we evaluated the impact of o ccurrence of poststroke seizures on both efficiency and effectiveness of rehabilitation and length of stay. Results: Poststroke late seizure s occurred in 46 (15.03%) patients, with a mean interval from stroke o f 101.98 +/- 37.96 days. In multiple regression analysis, putaminal an d lobar hemorrhages showed a significant positive association with the development of seizures (p < 0.005), whereas high scores on the Canad ian Neurological Scale (CNS) (indicating less severe strokes) and incr easing age were negatively associated (p < 0.01 and p < 0.05, respecti vely). Patients with putaminal and lobar hemorrhages and patients with severe stroke (CNS score at admission, < 7) were at significantly gre ater relative risk of seizures [relative risk (RR) = 1.99, 95% confide nce interval (CI), 1.11-1.39; RR = 3.00, CI, 1.06-1.13; and RR = 2.41, CI, 1.01-1.27, respectively). No significant association was found be tween poststroke seizures and results of rehabilitation.Conclusions: P oststroke late seizures occurred mainly in patients with putaminal and lobar hemorrhagic strokes but, if treated, did not affect rehabilitat ion therapy.