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Revisiting the Well-Established Subject of Stroke and Epilepsy

The Epidemiology of Post-Stroke Epilepsy According to Stroke Subtypes. Benbir G, Ince B, Bozluolcay M. Acta Neurol Scand 2006;114:8–12. Objectives Strokes represent the most common etiology of epilepsy in patients over the age of 60 years, with an incidence of 2–4% occurring in different studies. Materials and Methods In this observational study, 1,428 patients were included who had stroke and were admitted to our Stroke Unit between the years 1996 and 2005. Results Overall, 51 patients had post-stroke epilepsy (3.6%). Post-ischemic epilepsy occurred in 70.6% of the patients, post-hemorrhagic epilepsy occurred in 21.6% of the patients and epilepsy following venous infarctions occurred in 7.8% of all post-stroke epilepsy patients. Of 1,327 patients having ischemic stroke, 36 patients (2.7%), 11 out of 86 patients with hemorrhagic stroke (12.8%) and 4 of 15 patients with venous infarctions (26.6%) developed epilepsy. Compared with stroke patients without epilepsy, hemorrhagic (P < 0.001) and venous infarctions were more common in patients with post-stroke epilepsy (P < 0.001). The right hemisphere and the middle cerebral artery (MCA) territory were most commonly observed in ischemic and hemorrhagic stroke patients. Conclusions Our results indicate that post-stroke epilepsy is more common among patients who have experienced venous infarctions. Hemorrhagic and venous infarctions are more commonly encountered in post-stroke epilepsy patients. Atherosclerotic and cardioembolic strokes were similar to those that occurred in post-stroke epilepsy patients. Localizations in post-stroke epileptic patients showed that the majority occurred in the right hemisphere, in the territory of the MCA. However, prospective, multicentered studies are needed for a better understanding of the epidemiology and social impact of post-stroke epilepsy.