Prodromal and early epileptic seizures in acute stroke: does higher serum cholesterol protect?

In a case-control study, patients (n = 43/3,628) presenting seizures <1 week before (n = 6), < or =3 hours after (n = 26), and 3 to 24 hours after (n = 11) a first-ever stroke were studied. On multivariate analysis, they were characterized by lower levels of serum cholesterol (5.86 +/- 0.51 vs 6.34 +/- 0.58; p < 0.0001). Mortality and functional outcome at discharge were not influenced. Early poststroke seizures occur mainly during the critical 3-hour window for thrombolysis. Hypercholesterolemia appears to protect against seizures and cerebral ischemia.