Poststroke epilepsy: occurrence, predictors and treatment

Abstract

Although a well-known clinical phenomenon, there still remain some questions regarding the definitions, pathophysiology and epidemiology of early and late poststroke seizures and of poststroke epilepsy. Poststroke seizures and epilepsy constitute important complications in patients surviving a stroke. Several studies of the prevalence and possible predictors of poststroke seizures and epilepsy have been undertaken during the past few decades. Unfortunately, these studies have not consistently used the established definitions. There are only few studies concerning treatment of poststroke epilepsy in the elderly, especially regarding the effect of the newer antiepileptic drugs. The aim of this article is to give an overview of the latest studies of poststroke seizures, with special emphasis on poststroke epilepsy, by presenting data on occurrence, predictors and treatment. The results from the recent studies on both poststroke seizures (early and late) and poststroke epilepsy are quite consistent. Poststroke epilepsy appears to occur in 2–4% of patients. The most convincing predictors of late poststroke seizures and epilepsy and treatment options are discussed in this review.

Keywords::

• acute symptomatic seizure
• early seizures
• epilepsy
• late seizures
• poststroke epilepsy
• stroke

Acknowledgments

The authors thank Kari Mette Lillestølen and Karl Otto Nakken for their great help and support.