Objective To explore the impact of comprehensive nursing interventions on the incidence of ep-ilepsy and the prognosis in patients with acute stroke.Methods A total of 80 patients with acute stroke treated at Huanghe Sanmenxia Hospital from April 2022 to April 2024 were included in the study.They were divided into two groups based on the nursing intervention received:the experimental group(comprehensive nursing intervention)and the control group(conventional nursing intervention),with 40 patients in each group.The incidence of epilep-sy,neurological function,quality of life,patient satisfaction,and adverse reactions were compared between the two groups.Results The incidence of epilepsy in the experimental group was significantly lower than in the control group,with statistical significance(P<0.05).Prior to the intervention,there were no significant differences in neu-rological function and quality of life scores between the two groups(P>0.05).After the intervention,both groups showed a decrease in NIHSS scores(P<0.001)and an increase in BI scores and WHOQOL-BREF scores(P<0.001).The NIHSS scores in the experimental group were lower than those in the control group(P<0.001),while the BI and WHOQOL-BREF scores were higher in the experimental group(P<0.001).Patient satisfaction with nursing care in the experimental group was significantly higher than in the control group(P<0.05),and the incidence of complications was significantly lower in the experimental group(P<0.05).Conclusion Comprehensive nursing interventions reduce the incidence of secondary epilepsy in acute stroke patients,facilitate the recovery of neuro-logical function,improve quality of life,decrease the incidence of adverse reactions,and result in higher patient satisfaction.