Abstract DP153: Rate of Early Post-Stroke Seizures Has Not Changed Over Time: A Population-Based Study

Background: Post-stroke epilepsy (PSE) is a major contributor to the rising epilepsy burden among older individuals. Early post-stroke seizures (EPSS), a risk factor for PSE, may be affected by changing treatment patterns such as reperfusion in ischemic stroke, but it is unknown whether their prevalence is changing. We used a representative population-based study of stroke to examine the prevalence and trends of EPSS from 2005 to 2020. Methods: The Greater Cincinnati Northern Kentucky Stroke Study is an ongoing stroke surveillance study in the Greater Cincinnati region. Hospitalized strokes were ascertained and adjudicated by stroke physicians in calendar years 2005, 2010, 2015 and 2020. Stroke subtypes were categorized as ischemic strokes (IS), ischemic strokes with hemorrhagic transformation (IS-HT) and primary hemorrhagic stroke (HS, including intracerebral and subarachnoid hemorrhages). The presence of seizures was determined by chart review. EPSS were defined as all clinical or electrographic seizures that occurred during the pre-hospital setting or the initial hospitalization. Patients with history of seizures/epilepsy were excluded. Multivariable logistic regression was used to estimate the effect of study year on EPSS rate after adjusting for age, sex, and race; a second model also adjusted for stroke subtype. Results: We identified 10,312 stroke patients without history of epilepsy across all study periods, of whom 2375 (23.0%) were Black and 5552 (53.8%) were female. Demographics and subtypes are shown in Table 1; there was an increase in the percentage of individuals with IS-HT over time (from 4% in 2005 to 8% in 2020, trend P