Data from: The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors

Objective Our study objectives were to identify factors associated with
new-onset epilepsy and refractory epilepsy among older adult stroke
survivors and to evaluate the receipt of diagnostic care and mortality for
participants who developed epilepsy. Methods We conducted a
population-based, retrospective cohort study using linked, administrative
health care databases. The Ontario Stroke Registry was used to identify
patients 67 years and older who were hospitalized for a stroke at a
designated stroke center in Ontario, Canada, between April 1, 2003, and
March 31, 2009, and were previously free of epilepsy. Multivariable
Fine–Gray hazard models were used to examine risk factors of epilepsy and
refractory epilepsy, accounting for the competing risk of death. Results
Among 19,138 older adults hospitalized for a stroke, 210 (1.1%) developed
epilepsy and 27 (12.9%) became refractory to antiepileptic drugs. Within 1
year of epilepsy diagnosis, 24 (11.4%) patients were assessed with EEG and
19 (9.0%) with MRI. In multivariable analysis, younger age and
thrombolysis receipt significantly increased epilepsy risk. Lesser stroke
severity and anticoagulant medication receipt also significantly increased
epilepsy risk; however, these effects decreased over time. Younger age and
female sex were the only risk factors of refractory epilepsy. In the 5
years following epilepsy diagnosis, 97 (46.2%) participants died of any
cause. Conclusions Older adult stroke survivors are less likely to develop
epilepsy and pharmacologically refractory epilepsy. An estimated 86.6% of
deaths among older adult stroke survivors with new-onset epilepsy are
attributed to causes other than stroke or epilepsy.