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Poststroke epilepsy: current perspectives on diagnosis and treatment
Beata Sarecka-Hujar1, Ilona Kopyta2
1Department of Pharmaceutical Technology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Sosnowiec, Poland, beatasarecka@poczta.onet.pl.
Insights
Seizures and epilepsy are common after arterial ischemic stroke (AIS), particularly in children, leading to disability and increased mortality. Understanding risk factors for poststroke seizures (PSS) and epilepsy (PSE) is crucial for better prevention and treatment.
Area of Science:
- Neurology
- Stroke Medicine
- Epileptology
Background:
- Seizures and epilepsy are frequent complications following arterial ischemic stroke (AIS).
- These neurological consequences disproportionately affect pediatric populations compared to adults.
- Poststroke seizures (PSS) and epilepsy (PSE) can lead to significant disability and increased mortality.
Purpose of the Study:
- To review current perspectives on the diagnosis and treatment of PSS and PSE.
- To discuss the distinct phases of poststroke seizures: early PSS (EPSS) and late PSS (LPSS).
- To highlight the need for precise definitions and identification of risk factors for PSE.
Main Methods:
- Literature review of current research on poststroke seizures and epilepsy.
- Analysis of diagnostic criteria and treatment strategies for PSS and PSE.
- Examination of risk factors and prediction models for seizure development after AIS.
Main Results:
- AIS is a significant cause of seizures and epilepsy in both children and adults, with higher incidence in children.
- PSS is categorized into EPSS (within 7 days) and LPSS (up to 2 years post-AIS).
- Further research is needed to clarify the definition of PSE and identify predictive risk factors.
Conclusions:
- Accurate diagnosis and timely treatment of PSS and PSE are essential for improving patient outcomes.
- Identifying specific risk factors for seizures post-AIS can enhance preventative strategies.
- A comprehensive understanding of PSE development is critical for managing epilepsy in stroke survivors.
Abstract:
Seizures and epilepsy are quite a common outcome of arterial ischemic stroke (AIS) both in pediatric and adult patients, with distinctly higher occurrence in children. These poststroke consequences affect patients' lives, often causing disability. Poststroke seizure (PSS) may also increase mortality in patients with AIS. Early PSS (EPSS) occurring up to 7 days after AIS, late PSS (LPSS) occurring up to 2 years after the onset of AIS, as well as poststroke epilepsy (PSE) can be distinguished. However, the exact definition and cutoff point for PSE should be determined. A wide range of risk factors for seizures and epilepsy after AIS are still being detected and analyzed. More accurate knowledge on risk factors for PSS and PSE as well as possible prediction of epileptic seizures after the onset of AIS may have an impact on improving the prevention and treatment of PSE. The aim of the present review was to discuss current perspectives on diagnosis and treatment of PSS and PSE, both in adult and paediatric patients.
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