What is the impact of seizures on stroke?

This paper studied the impact of seizures on stroke. 

Stroke occurs when the brain does not receive enough blood. Seizures commonly occur during stroke. Seizures are changes in the brain’s electrical activity. This can cause violent shaking and loss of control or no symptoms at all. It is not clear whether outcomes are different for patients who develop seizures at the time of stroke compared to those who develop seizures following stroke during hospitalization.

This study compared the patient outcomes associated with seizures occuring during or after stroke.

1.53% of 10,261 patients had seizures when they had a stroke. Patients with seizures during stroke were more likely to be admitted to the intensive care unit (21.7%) than patients without seizures during stroke (8%). They were more likely to have seizures after stroke during hospitalization. They also had higher average levels of disability. These patients had increased mortality rates within 30 days or within 1 year than patients with no seizures when they had a stroke. A younger age, female sex, no weakness in movement, and a more severe stroke were associated with having seizures at stroke presentation.

2.0% of 10,261 patients had seizures after stroke while in the hospital. These patients had higher rates of depression (9.6%) than patients who did not have seizures after stroke (5.7%). 37.5% of these patients experienced hemineglect (they were no longer aware of one side of space, and ignored the left or right side), compared to 18.5% of those who did not have seizures. Importantly, these patients had more complications during hospitalization than those without seizures during hospitalization. These complications included pneumonia, urinary tract infection and pressure sores. A younger age and pneumonia were associated with seizures after stroke during hospitalization.

Seizures during hospitalization after stroke was associated with death within 30 days and within 1 year. Importantly, patients with less severe strokes had more health difficulties and mortality if they had seizures after stroke during hospitalization. 

The authors concluded that a seizure after stroke during hospitalization indicates a poorer outcome in patients.