{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:55:42Z","timestamp":1792619742448,"version":"4.5.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec id=\"ab-noi250012-4\"><jats:title>Importance<\/jats:title><jats:p>Poststroke epilepsy (PSE) is a major complication among young adults and is associated with problems with functional recovery and daily life. Although scores have been developed to predict risk of PSE, they have not been validated among patients with stroke at a young age.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi250012-5\"><jats:title>Objectives<\/jats:title><jats:p>To investigate both the risk of and risk factors for PSE at a young age and validate current PSE risk scores among a cohort of young adults.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi250012-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study used data from ODYSSEY (Observational Dutch Young Symptomatic Stroke Study), a prospective cohort study conducted among 17 hospitals in the Netherlands between May 27, 2013, and March 3, 2021, with follow-up until February 28, 2024. Participants included 1388 consecutive patients aged 18 to 49 years with neuroimaging-proven ischemic stroke or intracerebral hemorrhage (ICH) and without a history of epilepsy. Statistical analysis took place between June and August 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi250012-7\"><jats:title>Exposure<\/jats:title><jats:p>First-ever neuroimaging-proven ischemic stroke or ICH.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi250012-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Poststroke epilepsy was defined as at least 1 remote symptomatic seizure (&amp;amp;gt;7 days). Cumulative incidence functions were used to calculate the 5-year risk of PSE. Fine-Gray regression models were used to identify risk factors associated with PSE (age, sex, clinical stroke, and neuroimaging variables). The performances of the SeLECT (severity of stroke, large-artery atherosclerosis, early seizure, cortical involvement, and territory of middle cerebral artery) 2.0 risk score (for ischemic stroke) and the CAVE (cortical involvement, age, bleeding volume, and early seizure) risk score (for ICH) were assessed with C statistics and calibration bar plots.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi250012-9\"><jats:title>Results<\/jats:title><jats:p>This study included 1388 patients (ischemic stroke, 1231 [88.7%]; ICH, 157 [11.3%]; median age, 44.1 years [IQR, 38.0-47.4 years]; 736 men [53.0%]; median follow-up, 5.3 years [IQR, 3.4-7.4 years]), of whom 57 (4.1%) developed PSE. The 5-year cumulative risk of PSE was 3.7% (95% CI, 0.2%-4.8%) after ischemic stroke and 7.6% (95% CI, 3.5%-11.8%) after ICH. Factors associated with PSE after ischemic stroke were an acute symptomatic seizure (&amp;amp;lt;7 days) (hazard ratio [HR], 10.83 [95% CI, 2.05-57.07]; <jats:italic>P<\/jats:italic>\u2009=\u2009.005) and cortical involvement (HR, 5.35 [95% CI, 1.85-15.49]; <jats:italic>P<\/jats:italic>\u2009=\u2009.002). The only factor associated with PSE after ICH was cortical involvement (HR, 8.20 [95% CI, 2.22-30.25]; <jats:italic>P<\/jats:italic>\u2009=\u2009.002). The C statistic was 0.78 (95% CI, 0.71-0.84) for the SeLECT 2.0 risk score and 0.83 (95% CI, 0.76-0.90) for the CAVE risk score, and calibration was good for both scores.<\/jats:p><\/jats:sec><jats:sec id=\"ab-noi250012-10\"><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that the risk of PSE among young adults is relatively low and that the factors that were associated with PSE were similar to variables included in the existing risk scores, which can therefore also be applied for young adults after stroke. Future clinical trials should investigate the optimal primary and secondary prophylaxis for patients at high risk.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2025.0465","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T15:00:49Z","timestamp":1744642849000},"page":"597","source":"Crossref","is-referenced-by-count":23,"title":["Risk of Poststroke Epilepsy Among Young Adults With Ischemic Stroke or Intracerebral Hemorrhage"],"prefix":"10.1001","volume":"82","author":[{"given":"Esm\u00e9e","family":"Verburgt","sequence":"first","affiliation":[{"name":"Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Fellah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel S.","family":"Ekker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mijntje M. I.","family":"Schellekens","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther M.","family":"Boot","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maikel H. M.","family":"Immens","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayte E.","family":"van Alebeek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gelre Hospital, Apeldoorn, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J. A. M.","family":"Brouwers","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate M.","family":"Arntz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert W.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob A. R.","family":"Gons","sequence":"additional","affiliation":[{"name":"Department of Neurology, Catharina Hospital, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge W. M.","family":"van Uden","sequence":"additional","affiliation":[{"name":"Department of Neurology, Catharina Hospital, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"den Heijer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia H.","family":"van Tuijl","sequence":"additional","affiliation":[{"name":"Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karlijn F.","family":"de Laat","sequence":"additional","affiliation":[{"name":"Department of Neurology, Haga Hospital, The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk G.W.","family":"van Norden","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amphia Hospital, Breda, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Vermeer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian S. 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