While seizure is rarely associated with stroke during its hyperacute phase, Arboix found that the development of epileptic strokes within the first 48 hours post-stroke occurs about 2.4% of the time and portends a higher degree of in-patient mortality.
Seizure activity in the setting of acute stroke is more commonly associated with hemorrhagic types (4.3 % of cases), compared to just 2% with ischemic strokes.
Younger age, acute confusional states, hemorrhagic strokes, cortical strokes, and strokes affecting the frontal, parietal, occipital, and temporal lobes were found to be risk factors for stroke-related seizures.
The use of prophylactic anti-epileptic medication in the acute phase of stroke varies and, some say, requires further research; such treatment is more commonly reserved for use in hemorrhagic stroke patients, however, if at all.
References
Arboix et al. Predictive Factors of Early Seizures after Acute Cerebovascular Disease. Stroke.
