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【目的】探讨脑卒中后首次痫性发作的老年患者的临床特点和预后。【方法】回顾性分析120例继发于脑卒中的首次痫性发作的老年患者的临床资料，并电话随访其预后情况。【结果】两组患者在性别、年龄分布，住院天数，发作形式，持续状态，治疗方案，合并疾病，脑电图，生存状态等方面差异无统计学意义；而在生存情况方面30 d 内死亡率脑出血组显著高于脑梗死组，而30 d 后死亡率脑出血组显著低于脑梗死组，差异均具有统计学意义(P 均<0.05)。【结论】老年患者首次继发于脑出血的痫性发作很可能为近期预后不良的危险信号。“,”Objective]To investigate the clinical features and prognosis of elderly patients who suffered first-onset seizure after a stroke.[Methods]A retrospective analysis was conducted of 120 elderly patients with first-on-set seizure after a stroke.We recorded their detailed clinical features and follow-up telephone interviews.[Results]There were no significant differences between seizures after ischemia and hemorrhage stroke in the clinical features of sex,age,length of hospital stay,style of seizure,status of epilepsy or electroencephalogram.The rate of death within 30 days of incidence was higher among the hemorrhage stroke patients compared to among the ischemia pa-tients.However,the rate of death 30 days after incidence was higher among the ischemia patients.Both differences were statistically significant (P <0.05).[Conclusion]For elderly patients,first-onset seizure after a hemorrhage stroke may be a risk signal of death in the short term.