Clinical and Radiological Profile of Post-Stroke Seizures and Associated Factors in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Post-stroke seizure (PSS) is an important neurological complication that negatively impacts recovery, functional outcome, and quality of life in stroke survivors. However, data on its clinical and radiological characteristics in Bangladesh remain limited. Objective: The primary objective of this study was to delineate the clinical presentation and seizure characteristics of patients who developed seizures following a stroke. In parallel, radiological correlates were examined, with particular attention to the influence of stroke type, lesion location, and individual patient-related factors on seizure occurrence. Materials and Method:
Study place of this cross-sectional study was in the Department of Neurology at Dhaka Medical College Hospital from October 2023 to March 2025. A total of 100 adult patients with clinically and radiologically confirmed post-stroke seizures were enrolled using consecutive sampling. Structured questionnaires, clinical assessment, and neuroimaging was the data collection tools. Seizures classification was according to type and onset (early vs late). Associations were evaluated using the Chi-square () test, with p<0.05 considered statistically significant. Results: 57.93 ± 18 years was the mean age of the participants, with male predominance (60%). Hypertension (74%) was the most common comorbidity. Focal seizures were most frequent (39%), followed by generalized (32%) and focal to bilateral tonic–clonic seizures (29%). Early-onset seizures occurred in 62% of patients. Ischemic stroke was the most common subtype (57%), while cortical involvement was observed in 76% of cases, predominantly in the parieto-temporal region. Early-onset seizures were significantly associated with cortical lesions (72.4%), hemorrhagic stroke (81.1%), and venous stroke (100%) (p=0.001). Age (p=0.025), sex (p=0.001), and stroke type (p=0.001) were significantly associated with seizure type. Conclusion: Post-stroke seizures were predominantly early in onset and strongly associated with cortical involvement and hemorrhagic stroke. Stroke subtype and lesion location significantly influenced seizure characteristics, emphasizing the importance of early risk stratification and monitoring in high-risk patients.

J Med Coll Women Hosp.2026; 22(2): 186-197