[Post-stroke epilepsy].

Abstract

The frequency of cerebrovascular aetiology of epilepsy is estimated at 3-30%, and the rate is significantly higher in studies carried out in developed world. Early seizures, variously defined by different authors (usually as those occurring within first week or first two weeks after stroke) occur in 2.5-6% of patients, in most of them within the first 24 hours after stroke. Early seizures constitute a major risk factor of poststroke epilepsy, but in many patients seizures do not recur after acute phase of stroke. The pathophysiology of poststroke seizures is not fully elucidated, probably it is different for early and late seizures. Several investigations evaluated the connection between seizures and localization of vascular foci, the results are not consistent; most investigators believe that seizures occur more frequently in cases of cortical localization of the focus. Seizures are more common in haemorrhagic than in ischaemic strokes. The most common type of seizures are simple partial seizures, the rarest are complex partial seizures. The prognostic value of EEG is of little importance: nevertheless, in poststroke patients who had at least one seizure, diffuse slowing of background activity or PLED are associated with increased risk of seizure recurrence. Early seizures do not require long-term antiepileptic treatment; late seizures usually well respond to treatment.