Clinical and radiological evaluation of epilepsy after ischemic cerebrovascular disease
Journal Title: Gulhane Medical Journal - Year 2020, Vol 62, Issue 2
Abstract
Aims: We aimed to evaluate the onset time, seizure type, response to treatment, etiological causes, electroencephalographic, and radiological features of epileptic seizures that occur after ischemic stroke. Methods: A retrospective evaluation was performed using the data of 2900 patients admitted to our clinic between October 2016 and June 2019 and diagnosed with ischemic stroke. Those who had epileptic seizures within the first 15 days after ischemic cerebrovascular disease were considered as early-onset seizures (EOS), and those who started on or after day 16 were considered as late-onset seizures (LOS). Results: The study was conducted on 46 patients who had epileptic seizures after ischemic stroke. EOS were detected in 28 of the patients (60.9%) and LOS in 18 (39.1%). When ischemia etiologies were examined, cardioembolism was found in approximately half of the cases (47.8%). Secondary generalized tonic-clonic seizure (SGTCS) (52.2%) and complex partial seizure (26.1%) were the most common ones in patients. Monotherapy was performed in 39 patients (84.8%) and polytherapy in 7 patients (15.2%). A focal epileptiform anomaly was the most frequent abnormality in electroencephalography. The most common involvement in both EOS and LOS was observed in the cortical and subcortical areas. Conclusions: EOS were more frequent after ischemic stroke. Cortical and subcortical involvement was the most common in terms of seizures in radiological examination. The most common seizure type was SGTCS. Monotherapy was the most frequent application in the treatment. The most commonly preferred antiepileptic drug was levetiracetam. Antiepileptic drug therapy was found to be effective.
Authors and Affiliations
Akçay Övünç Özön, Ferhat Cüce
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