Skip to main content
SpringerLink
Log in

Post-stroke epilepsy

  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Seizures occur in about 10% of stroke patients. Hence, stroke is the most common cause of seizures and epilepsy in the elderly population. Five percent are early-onset seizures (peak onset within the first day after the stroke) and another 5% are late-onset seizures (peak onset within 6 to 12 months after the stroke). Epilepsy (ie, recurrent seizures) develops in 3% to 4% of the stroke patients (in about one third of the patients with early-onset seizures and about one half of the patients with late-onset seizures). There is a strong positive correlation between stroke severity and the risk of post-stroke seizures; the risk is very low in mild strokes. Seizures are more common in hemorrhagic stroke and in stroke with cortical involvement. Whether this is due to the hemorrhagic component or the cortical involvement per se, or a reflection of more severe strokes among patients with hemorrhagic strokes and lesions involving cortical structures, is not clear. The influence of seizures on outcome is still a matter of controversy. Although epileptic seizures are considered easy to control, this is not supported by evidence from randomized controlled trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Krämer G: Epilepsy in the elderly. Stuttgart: Georg Thieme Verlag; 1999.

    Google Scholar 

  2. Bladin CF, Alexandrov AV, Bellavance A, et al. for the Seizure After Stroke Study: Seizures after stroke. A prospective multicenter study. Arch Neurol 2000, 57: 1617–1622.

    Article  PubMed  CAS  Google Scholar 

  3. Kilpatrick CJ, Davis SM, Tress BM, et al.: Epileptic seizures in acute stroke. Arch Neurol 1990, 47: 157–160.

    PubMed  CAS  Google Scholar 

  4. Reith J, Jørgensen HS, Nakayama H, et al.: Seizures in acute stroke: Prediction and prognostic significance. The Copenhagen Stroke Study. Stroke 1997, 1585–1589.

  5. Giroud M, Gras P, Fayolle H, et al.: Early seizures after acute stroke: a study of 1,640 cases. Epilepsia 1994, 35: 959–964.

    Article  PubMed  CAS  Google Scholar 

  6. Berges S, Moulin T, Berger E, et al.: Seizures and epilepsy following strokes: recurrence factors. Eur Neurol 2000, 43: 3–8.

    Article  PubMed  CAS  Google Scholar 

  7. Burn J, Dennis M, Bamford J, et al.: Epileptic seizures after first stroke: the Oxforshire community stroke project. BMJ 1997, 315: 1582–1587.

    PubMed  CAS  Google Scholar 

  8. Arboix A, Garcia-Eroles L, Massons JB, et al.: Predictive factors of early seizures after acute cerebrovascular disease. Stroke 1997, 28: 1590–1594.

    PubMed  CAS  Google Scholar 

  9. So EL, Annegers JF, Hauser WA, et al.: Population-based study of seizure disorders after cerebral infarction. Neurology 1996, 46: 350–355.

    PubMed  CAS  Google Scholar 

  10. Olsen TS, Høgenhaven H, Thage O: Epilepsy after stroke. Neurology 1987, 37: 1209–1211.

    PubMed  CAS  Google Scholar 

  11. Louis S, McDowell F: Epileptic seizures in nonembolic cerebral infarction. Arch Neurol 1967, 17: 414–418.

    PubMed  CAS  Google Scholar 

  12. Fentz V: Epileptic seizures in patients with cerebro-vascular accidents. Nordisk Medicin 1971, 86: 1023–1025.

    PubMed  CAS  Google Scholar 

  13. Richardson EP, Dodge PR: Epilepsy in cerebral vascular disease. Epilepsia 1954, 3: 49–74.

    PubMed  Google Scholar 

  14. Kilpatrick C, Davis SM, Hopper JL, Rossiter SC: Early seizures after acute stroke. Risk of late seizures. Arch Neurol 1992, 49: 509–511.

    PubMed  CAS  Google Scholar 

  15. Gupta SR, Naheedy MH, Elias D, Rubino FA: Postinfarction seizures. A clinical study. Stroke 1988, 19: 1477–1481.

    PubMed  CAS  Google Scholar 

  16. Lancman ME, Golimstok A, Norscini J, Granillo R: Risk factors for developing seizures after a stroke. Epilepsia 1993, 34: 141–143.

    Article  PubMed  CAS  Google Scholar 

  17. Berger AR, Lipton RB, Lesser ML, et al.: Early seizures following intracerebral hemorrhage: Implications for therapy. Neurology 1988, 38: 1363–1365.

    PubMed  CAS  Google Scholar 

  18. Faught E, Peters D, Bartolucci A, et al.: Seizures after primary intracerebral hemorrhage. Neurology 1989, 39: 1089–1093.

    PubMed  CAS  Google Scholar 

  19. Weisberg LA, Shamsnia M, Elliott D: Seizures caused by non-traumatic parenchymal brain hemorrhages. Neurology 1991, 41: 1197–1199.

    PubMed  CAS  Google Scholar 

  20. Pohlman-Eden B, Cochius JI, Hoch DB, Hennerici MG. Stroke and epilepsy: critical review of the literature. Part II: Risk factors, pathophysiology and overlap syndromes. Cerebrovasc Dis 1997, 7: 2–9.

    Google Scholar 

  21. Shinton RA, Gill JS, Zezulka AV, Beevers DG: The frequency of epilepsy preceding stroke. Case-control study in 230 patients. Lancet 1987, 1: 11–13.

    Article  PubMed  CAS  Google Scholar 

  22. Starkey IR, Warlow CP: Epilepsy preceding stroke [letter]. Lancet 1987, 1: 742–743.

    Article  PubMed  CAS  Google Scholar 

  23. Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS: Silent infarction in first-ever stroke patients. Stroke 1994, 25: 2293–2294.

    Google Scholar 

  24. Bogousslavsky J, Martin R, Regli F, et al.: Persistent worsening of stroke sequelae after delayed seizures. Arch Neurol 1992, 49: 385–388.

    PubMed  CAS  Google Scholar 

  25. Arboix A, Comes C, Massons J, et al.: Relevance of early seizures for in-hospital mortality in acute cerebrovascular disease. Neurology 1996, 47: 1429–1435.

    PubMed  CAS  Google Scholar 

  26. Bladin CF, Norris JW: Stroke and seizure/epilepsy. In Primer on Cerebrovascular Diseases. Edited by Welch KMA, Caplan LR, Reis DJ, Siesjö BK, Weir B. San Diego: Academic Press; 1997:355–358.

    Google Scholar 

  27. Smith B: Management of seizures in acute stroke. In Primer on Cerebrovascular Diseases. Edited by Welch KMA, Caplan LR, Reis DJ, Siesjö BK, Weir B. San Diego: Academic Press; 1997:706–708.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Gentofte University Hospital, DK 2900, Hellerup, Denmark

    Tom Skyhøj Olsen MD, PhD

Authors
  1. Tom Skyhøj Olsen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Olsen, T.S. Post-stroke epilepsy. Curr Atheroscler Rep 3, 340–344 (2001). https://doi.org/10.1007/s11883-001-0029-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11883-001-0029-4

Keywords

Search

Navigation