Post-stroke seizures in a Sub-Saharan tertiary healthcare center

Abstract

Background: Stroke is a severe neurological condition. Seizures are a common complications of stroke. The aim of this study was to describe the clinical features of post-stroke seizures (PSS) in Cameroon. Methods: Using the Douala General hospital’s stroke registry, we collected data on stroke cases admitted from January 1, 2010, to December 31, 2016. We included patients aged above 15 years diagnosed of stroke using neuroimaging. PSS was defined as the onset of at least one seizure after stroke. Preexisting epilepsy, others causes of seizures (brain infections, metabolic disorders), tumors, brain trauma, and subarachnoid hemorrhage, and incomplete files were excluded. Outcome variables were in-hospital mortality and poor functional recovery with a modified Rankin scale (mRS) > 2 at six months. Results: Among the 913 cases of stroke, 124 patients presented post-stroke seizures (13.6%) including 108 early onset seizures (< 30 days). The mean age of patients was 61.52 ± 13.20 years, and 54% were male. Seizures were generalized in 69.44%, and 8.33% presented status epilepticus. In hospital mortality was 27.9% in PSS vs. 25% stroke without seizures (SWS) patients (p = 0.548). At six months the functional recovery was poor (mRS > 2) in 39.4% of PSS vs. 31.7% SWS patients (p = 0.642). After a follow up of 18 months, less than 6% of PSS patients have a seizure recurrence. Conclusion: There is no significant difference in in-hospital mortality and poor functional recovery at 6 months in patients with and without post-stroke seizures. Keywords: stroke, seizures, coma, Cameroon.