Purpose of review: In this review, we summarize the recent literature regarding the incidence and treatment of seizures arising after ischemic and hemorrhagic strokes. Additionally, we identify open questions in guidelines and standard clinical care to aid future studies aiming to improve management of seizures in post-stroke patients.
Recent findings: Studies demonstrate an increasing prevalence of seizures following strokes, probably a consequence of advances in post-stroke management and expanding use of continuous EEG monitoring. Post-stroke seizures are associated with longer hospitalization and increased mortality; therefore, prevention and timely treatment of seizures are important. The standard of care is to treat recurrent seizures with anti-epileptic drugs (AEDs) regardless of the etiology. However, there are no established guidelines currently for prophylactic use of AEDs following a stroke. The prevalence of post-stroke seizures is increasing. Further studies are needed to determine the risk factors for recurrent seizures and epilepsy after strokes and optimal treatment strategies.
Keywords: Cerebrovascular disease; Epilepsy; Hemorrhagic stroke; Ischemic stroke; Post-stroke seizures; Seizures.
High Risk of Seizures and Epilepsy After Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery StrokeR Brondani et al. Cerebrovasc Dis Extra 7 (1), 51-61. PMID 28359069.The incidence of seizures and epilepsy after malignant MCA infarcts submitted to DHC might be very high. Seizure might occur precociously in patients who are not submitte …
Mortality and Trends in Stroke Patients With Seizures: A Contemporary Nationwide AnalysisA Lekoubou et al. Epilepsy Res 156, 106166. PMID 31404715.Overall 372,957 patients (6%) stroke patients had a secondary diagnosis of seizures. We found 29% higher odds of in-hospital death among stroke patients with a secondary …
Incidence and Management of Seizures After Ischemic Stroke: Systematic Review and Meta-AnalysisJZ Wang et al. Neurology 89 (12), 1220-1228. PMID 28835405. - ReviewThe burden of stroke-related seizures and epilepsy due to ischemic stroke is substantial. Further studies are required to determine risk factors for epilepsy following is …
Cerebrovascular Accidents During Mechanical Circulatory Support: New Predictors of Ischemic and Hemorrhagic Strokes and OutcomeS Izzy et al. Stroke 49 (5), 1197-1203. PMID 29643259.Stroke is a major cause of morbidity and mortality in patients on LVAD support. Chronic obstructive pulmonary disease increases the risk of ischemic stroke, whereas dialy …
Anti-epileptic Drug (AED) Use in Subarachnoid Hemorrhage (SAH) and Intracranial Hemorrhage (ICH)R Feng et al. Curr Pharm Des 23 (42), 6446-6453. PMID 29086673. - ReviewAneurysmal subarachnoid hemorrhage (aSAH) and spontaneous intracranial hemorrhage (ICH) are frequently associated with epileptic complications. The use of anti-epileptic …