Background and purpose

Poststroke epilepsy is a common problem in clinical practice. This study aimed to determine the predictors of poststroke epilepsy and to identify the risk factors.

Methods

A total of 436 patients were enrolled for this study. Baseline characteristics were recorded. Patients were followed up for 3 years. According to the occurrence of late seizures (i.e., seizure occurring 8 days or later after the stroke), the patients were separated into two groups: a seizure group and a seizure-free group. Baseline characteristics were compared between the groups. Univariate and multivariate Cox regression analysis was used to identify the risk factors for occurrence of poststroke epilepsy. The study was registered in the University Hospital Medical Information Network Center Clinical Trials Registry (registration number UMIN000009659, date 28/December/2012).

Results

Among the 436 patients, 26 developed late seizures—an incidence rate of 5.96%. In univariate analysis, female, subarachnoid hemorrhage, hemorrhagic lesion, lesion affecting the cortex, lesion affecting the frontal lobe, and absence of comorbidities were the significant risk factors for occurrence of epilepsy. In multivariate analysis, the independent predictors of poststroke epilepsy were hemorrhagic lesion (hazard ratio (HR) = 3.03) and lesion location in the cortex (HR = 4.64). The incidence of poststroke epilepsy in patients with both two risk factors was 15.4%.

Conclusions

Poststroke epilepsy occurs in almost 6% of patients within 3 years after stroke onset. Hemorrhagic stroke and subcortical lesion appear to be significantly associated with likelihood of developing epilepsy. Thus, prophylactic administration of antiepileptic drugs could be useful for stroke patients with these two risk factors.

中文翻译：

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中风后癫痫的调查研究（INPOSE）：一项用于预测中风后癫痫的多中心前瞻性研究。

背景和目的

中风后癫痫是临床实践中的常见问题。这项研究旨在确定中风后癫痫的预测因素，并确定危险因素。

方法

共有436名患者参加了这项研究。记录基线特征。对患者随访3年。根据迟发性癫痫发作的发生（即中风后8天或更晚发作），将患者分为两组：癫痫发作组和无癫痫发作组。比较两组之间的基线特征。使用单因素和多因素Cox回归分析来确定中风后癫痫发生的危险因素。该研究已在大学医院医学信息网络中心临床试验注册中心注册（注册号UMIN000009659，日期28 / December / 2012）。

结果

在436例患者中，有26例发展为癫痫晚期，发生率为5.96％。在单变量分析中，女性，蛛网膜下腔出血，出血性病变，病变累及皮质，病变累及额叶病变和无合并症是发生癫痫的重要危险因素。在多变量分析中，卒中后癫痫的独立预测因素是出血性病变（危险比（HR）= 3.03）和病变在皮层中的位置（HR = 4.64）。具有这两种危险因素的患者中风后癫痫的发生率为15.4％。

结论

中风发作后3年内，近6％的患者发生中风后癫痫。出血性中风和皮层下病变似乎与发生癫痫的可能性显着相关。因此，预防性使用抗癫痫药可能对患有这两种危险因素的中风患者有用。