Seizure Incidence in Ischemic Stroke Patients Treated with and without tPA: A Single Center Study (P4.292)

Objective: To compare the seizure incidence in ischemic stroke patients treated with and without tissue plasminogen activator (tPA) at our comprehensive stroke center. Background: Due to the rapid advances in stroke treatment, our center has had an increasing numbers of patients who are treated with tPA. Acute seizures following ischemic stroke leads to poorer outcomes and increased mortality. Studies have found that 6% of patients have seizures within 24 hours of a stroke. We aim to assess the incidence of early-onset post-stroke seizure in our patient population treated with and without tPA. Design/Methods: We retrospectively reviewed 1332 patients who had an ischemic stroke and were treated with and without tPA at our hospital from January 2014 to July 2016. Demographics, onset of the seizure, and time to tPA treatment were recorded. Patients who had seizures after 24 hours of stroke onset were excluded. Results: Of the 1332 patients identified, 48 (3.6%) patients had post-stroke seizures. This included 6 of the 411 patients (1.45%) who were treated with tPA and 42 of the 921 patients (4.56%) who were not treated with tPA (OR=0.31, CI=0.13–0.73, p=0.0079). When compared to the reported average, the overall occurrence of early-onset seizures at our center is low (p=0.0002). The incidence of seizures within 24 hours in our patient population is lower in those who treated with tPA when compared to those who were not (p=0.0025). Conclusions: Treatment with tPA reduces the incidence of early onset seizures in stroke patients. Further studies would be needed to clarify the effect of tPA administration on the incidence of seizures after 24 hours. Disclosure: Dr. Vaidyanathan has nothing to disclose. Dr. Hawkins has nothing to disclose. Dr. Morris has nothing to disclose.