Epileptic seizures in cerebral arterial occlusive disease

The occurrence of epileptic seizures was investigated in 141 patients with angiographically proven carotid or MCA occlusive disease. Epileptic seizures occurred some time during the clinical course of the disease in 17.3% of carotid patients and in 10.8% of MCA patients, being mainly represented by partial motor seizures. The pattern of occurrence of seizures in the natural history of cerebral arterial disease was different in the two groups. In the carotid group, epilepsy was the presenting symptom in 6.7% of patients, whereas no MCA patient had seizures prior to the appearance of a neurological deficit. Since epileptic seizures may complicate an otherwise asymptomatic carotid obstruction, angiography should be performed whenever the other standard investigations, including CT-scan, fail to reveal the cause of late-onset epilepsy.