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Poststroke seizures in the elderly.

J J Asconapé1, J K Penry

  • 1Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.

Clinics in Geriatric Medicine
|August 1, 1991
PubMed
Summary
This summary is machine-generated.

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Strokes are a common cause of seizures in the elderly. Early seizures typically resolve, while late seizures after stroke may indicate epilepsy requiring chronic treatment.

Area of Science:

  • Neurology
  • Epileptology
  • Cerebrovascular Disease

Background:

  • Strokes are the leading cause of epilepsy in older adults.
  • Seizures occur in 5% to 10% of acute stroke cases.
  • Understanding seizure types (early vs. late) is crucial for prognosis.

Purpose of the Study:

  • To differentiate between early and late seizures post-stroke.
  • To explore the underlying mechanisms and risk factors for seizures after stroke.
  • To provide guidance on the management of seizures and epilepsy following cerebrovascular events.

Main Methods:

  • Review of existing literature on stroke-related seizures.
  • Analysis of seizure characteristics, timing, and etiological factors.
  • Evaluation of treatment strategies for early and late seizures.

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Main Results:

  • Early seizures are transient, focal, and linked to acute metabolic changes.
  • Late seizures suggest structural abnormalities and often lead to epilepsy.
  • Cortical involvement increases seizure risk; deep lesions rarely cause seizures.
  • Hemorrhagic and embolic strokes may have higher seizure incidence, but evidence is limited.
  • Seizure presence does not correlate with stroke size, outcome, or mortality.

Conclusions:

  • Epilepsy is more likely to follow late seizures after stroke.
  • Prophylactic antiepileptic drugs are generally not recommended, except after subarachnoid hemorrhage.
  • Early seizures may require short-term treatment; late seizures warrant chronic anticonvulsant therapy.