[Post-stroke epilepsy]

To study the characteristics and clinical course of the seizures in patients with post-stroke epilepsy, to evaluate the clinical behaviour of the epilepsy depending on the early or late onset of the seizures, and to analyse the effectiveness of antiepileptic treatment.

Since 1990, a total of 1400 patients have been analysed at the epilepsy service. Epilepsy was diagnosed as having a vascular origin in 69, and after suffering a stroke 41. A retrospective study was conducted with the following eligibility criteria: suffering a stroke and, later, at least one crisis as a result of the first event.

Mean age at the time of the stroke: 54.7 +/- 20.5 years (range: 3-85 years).

7.6 years (53.7% over 5 years). Type of stroke: ischaemic, 75.6%, and haemorrhagic 24.4%. Aetiology of the stroke: atherothrombotic, 29.2%, and cardioembolic, 24.4%. Mean interval between the stroke and the first seizure: 18 months (range: 0-17 years) (six patients the same day the stroke occurred, all of which were haemorrhagic). Type of seizures: secondarily generalised partial, 60.9%; generalised primary, 21.9%; and partial, 17.1%. Single crisis: 19.5%. Early seizures, 36.6%, and late, 63.4%. In all, 19.1% of the patients suffered a single crisis after the stroke.

phenytoin (43.9%), carbamazepine (19.5%) and lamotrigine (19.5%). Fourteen patients required combination therapy. At the end of the follow-up 53.7% were free of seizures.

In the analysis that was performed, an association was found between a cardioembolic aetiology and late onset of the seizures. On comparing the type of seizures, early versus late, the courses paralleled each other in the two types of patients. A little over half the patients were free of seizures.