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Published on: October 2, 2014
Single seizure and epilepsy in patients with a cerebral territorial infarct
Jacques De Reuck1, Liesbeth De Groote, Georges Van Maele
1Department of Neurology, University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. dereuck@gmail.com
Background:
The risk factors to develop stroke-related seizures are actually better understood. However, it is not known which patients are at risk to develop recurrent seizures and epilepsy.
Objectives:
This retrospective study compares the characteristics of patients with a territorial infarct who develop a single seizure to those who develop epilepsy.
Patients And Methods:
The demographic and clinical features, the seizure type and onset time, the infarct location and the electroencephalographic (EEG) findings of 106 stroke patients with a single seizure and of 89 ones with epilepsy are compared.
Results:
No differences in age, gender, vascular risk factors, stroke type and aetiology, and post-ictal EEG are observed between both groups. The most significant difference is the time of seizure onset, with a low recurrence rate in patients with early- compared to those with late-onset after stroke. Patients with a primary generalised tonic-clonic insult and with a subcortical infarct are less at risk of seizure recurrence.
Conclusions:
The main consequences of these findings are that patients with early-onset seizures do not need sustained antiepileptic drugs (AEDs) after the acute treatment. Patients who develop late-onset seizures need AEDs after the first spell.
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