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 1...