Risk of Poststroke Epilepsy Among Young Adults With Ischemic Stroke or Intracerebral Hemorrhage

作者：Esmée Verburgt, Lina Fellah, Merel S. Ekker, Mijntje M.I. Schellekens, Esther M. Boot, Maikel HM Immens, Mayte E. van Alebeek, Paul J.A.M. Brouwers, Renate M. Arntz, Gert W. van Dijk, Rob A.R. Gons, Inge W.M. van Uden, Tom den Heijer, Julia H. van Tuijl, Karlijn F. de Laat, Anouk G.W. van Norden, Sarah E. Vermeer, Marian S.G. van Zagten, Robert J. van Oostenbrugge, Marieke J.H. Wermer, Paul J. Nederkoorn, Henk Kerkhoff, Fergus A. Rooyer, Frank G. van Rooij, Ido R. van den Wijngaard, Anil M. Tuladhar, Jamie I. Verhoeven, Nina A. Hilkens, Frank-Erik de Leeuw · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.0465 · 被引用次数：18 · 研究领域：Epilepsy research and treatment、Psychosomatic Disorders and Their Treatments、Traumatic Brain Injury and Neurovascular Disturbances

Importance: Poststroke epilepsy (PSE) is a major complication among young adults and is associated with problems with functional recovery and daily life. Although scores have been developed to predict risk of PSE, they have not been validated among patients with stroke at a young age. Objectives: To investigate both the risk of and risk factors for PSE at a young age and validate current PSE risk scores among a cohort of young adults. Design, Setting, and Participants: This cohort study used data from ODYSSEY (Observational Dutch Young Symptomatic Stroke Study), a prospective cohort study conducted among 17 hospitals in the Netherlands between May 27, 2013, and March 3, 2021, with follow-up until February 28, 2024. Participants included 1388 consecutive patients aged 18 to 49 years with neuroimaging-proven ischemic stroke or intracerebral hemorrhage (ICH) and without a history of epilepsy. Statistical analysis took place between June and August 2024. Exposure: First-ever neuroimaging-proven ischemic stroke or ICH. Main Outcomes and Measures: Poststroke epilepsy was defined as at least 1 remote symptomatic seizure (>7 days). Cumulative incidence functions were used to calculate the 5-year risk of PSE. Fine-Gray regression models were used to identify risk factors associated with PSE (age, sex, clinical stroke, and neuroimaging variables). The performances of the SeLECT (severity of stroke, large-artery atherosclerosis, early seizure, cortical involvement, and territory of midd...