Structural-morphometric and clinical-encephalographic features of epilepsy in patients in the late recovery period of ischemic stroke (literature review)

Yu.M. Vynnyk, I.B. Yaroschuk


Background. In recent years, there has been a significant increase in the incidence of epilepsy in people of older age groups all over the world. One of the most common risk factors for the development of epileptic seizures is cerebrovascular disease. It is believed that 10–30 % of the newly diagnosed epileptic seizures in patients over 60 years of age occur after a stroke, which further complicates the clinical picture of the disease and causes a deterioration in the quality of life of patients, slows down the recovery of functions lost due to a stroke, enhances cognitive and mnemonic disorders, increases the risk of sudden death, which, in turn, requires a revision of ongoing therapy taking into account the pharmacological interaction of drugs. In addition, it has been reliably established that an epileptic seizure that was detected for the first time at the age over 60 years significantly increases the risk of primary and repeated stroke. Despite a long period of studying this problem, the diagnosis of post-stroke epilepsy is difficult to date due to the lack of a unified position regarding understanding of its pathogenesis, different definitions of diagnosis, biased interpretation of interictal electroencephalography. The purpose was to analyze the literature data on structural-morphometric and clinical-encephalographic features of epilepsy in patients at different periods of ischemic stroke, the probability of risk of post-stroke epilepsy onset. Materials and methods. Existing publications related to post-stroke epilepsy issues were analyzed by search in databases, such as the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and Medline. Appropriate randomized controlled trials were selected, however, due to the lack of review studies and meta-analyses, this work includes, in particular, observational and epidemiological studies. Results. In most of the studies analyzed, the authors showed a large variability in the frequency of post-stroke epilepsy. High variability is explained by the features of stroke course in different populations, the different definitions of the diagnosis of post-stroke epilepsy, and the different design of the studies. However, most studies found that the risk of developing post-stroke epilepsy doubles from the first to the fifth year after a stroke, and is about 4.2–5 %. Conclusions. Thus, the study of neurofunctional and structural-morphometric changes in patients with epilepsy in the late recovery period of ischemic stroke is an important problem of clinical neurology, many aspects of which today have ambiguous, often contradictory interpretations. Therefore, the study of this relationship will allow for a better understanding of the pathogenesis of post-stroke epilepsy, will expand the possibilities of its therapy and diagnosis.


post-stroke epilepsy; ischemic stroke; encephalography; review


Гехт А.Б., Лебедева А.В., Полетаев А.Б. и др. Постинсультная эпилепсия. Инсульт. 2003. № 9. С. 195.

Дубенко А.Е. Эпилепсия у лиц пожилого возраста, особенности клиники, диагностики и лечения. Нейро NEWS: психоневрологія та нейропсихіатрія. 2010. № 2/1. С. 5-15.

Forsgren L., Bucht G., Eriksson S., Bergmark L. Incidence and clinical characterization of unprovoked seizures in adults: a prospective population based study. Epilepsia. 1996. № 37. Р. 224-229.

Lossius M.I., Røning O.M., Gjerstad L. Post-stroke epilepsy. Tidsskr nor laegeforen. 2004. № 124(5). Р. 620-622.

Шнайдер Н.А., Чацкая А.В., Дмитренко Д.В., Шевченко О.И. Постинсультная эпилепсия. Междунар. неврол. журн. 2007. № 4. С. 3-7.

Гехт А.Б., Лебедева А.В., Рулева З.С. и др. Эпилепсия у больных инсультом. Рос. мед. журн. 2000. № 2. С. 14-17.

Hauser W.A., Shih T., Leary L., Bagiella E., Dayan P., Green R., Andrews H., Thurman D.J., Hesdorffer D.C. Estimating the incidence of first unprovoked seizure and newly diagnosed epilepsy in the low-income urban community of Northern Manhattan, New York City. Epilepsia. 2008.

Власов П.Н., Шахбасова З.С. и др. Эпилепсия, впервые возникшая у пожилого пациента: диагностика, дифференциальная диагностика, терапия. Фарматека. 2010. № 7. С. 40-46.

Shapiro I.M., Neufeld M.Y., Korczyn A.D. Seizures of unknown origin after the age of 50: vascular risk factors. Acta Neurologica Scandinavica. 2009. 82. 1(78–80).

Verellen R.M., Cavazos J.E. Pathophysiological considerations of seizures, epilepsy and status epilepticus in the elderly. Aging Dis. 2011. 2. Р. 278-85.

Camilo O., Golgstein L.B. Seizures and epilepsy after ischemic stroke. Stroke. 2004. Vol. 35. № 7. P. 1769-1775.

Lossius M.I., Ronning O.M., Slapo G.D. et al. Post-stroke epilepsy: occurrence and predictors — a long-term prospective controlled study Akershus Stroke Study. Epilepsia. 2005. Vol. 46. № 8. P. 1246-1251.

Bladin C.F., Alexandrov A.V., Bellavance A., Bornstein N., Chambers B., Cote R., Lebrun L., Pirisi A., Norris J.W. Seizures after stroke: a prospective multicenter study. Arch. Neurol. 2000. 57. Р. 1617-1622.

Seitz R.J., Donnan G.A. Recovery Potential After Acute Stroke. Front. Neurol. 2015, Nov 11. 6. Р. 238. doi: 10.3389/fneur.2015.00238. eCollection 2015.

Zaidi A., Clough P., Cooper P. et al. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J. Am. Cool. Cardiol. 2000. Vol. 36. № 1. P. 181-184.

Маджидова Р.Н. Структурные особенности судорожных синдромов у больных с инсультом. Неврология. 2004. Т. 4. № 24. С. 15-17.

Huguenard J.R. Neuronal circuitry of thalamocortical epilepsy and mechanisms of antiabsence drug action. Stanford University Medical Center, California, USA. Adv. Neurol. 1999. 79. Р. 991-9.

Крыжановский Г.Н. Введение в общую патофизиологию. Москва: Наука, 2000. 71 с.

Матюха С. Эпилепсия в пожилом воздасте. Expert Reviews Neurotherapeutics. 2010. № 10(12). С. 1899-1910.

Карлов В.А. Развивающийся, инволюционирующий мозг, цереброваскулярные заболевания и эпилепсия. Журнал неврологии и психиатрии им. С.С. Корсакова. 2009. 3. С. 4-7.

Зенков Л.Р. Непароксизмальные эпилептические расстройства: Руководство для врачей. Москва: МЕДпресс-информ, 2008. С. 75-106.

Steriade M. Cellular substrates of brain rhythms. In: Neadermeyer E., Lopas de Silva, eds. Electroencephalography: basic principles, clinical applications and related fieldes. Baltimore: Williams and Wilkins,1998, 2003. Р. 27-62.

Nakajima Y., Homma S., Musha T. Dipole-tracing of abnormal slow brain potentials after cerebral stroke — EEG, PET, MRI correlations. Neuroscience Let. 1999. № 112. Р. 59-64.

Kaplan P.W., Lesser R.P. Long term EEG monitoring. Chapter 16 in «Current Practice of Clinical electroenceph». Raven Press. 1999. Р. 513-586.

Eyal Y. Kimchi, Anudeepthi Neelagiri еt al. Clinical EEG slowing correlates with delirium severity and predicts poor clinical outcomes. Neurology. Sept 24, 2019. 93(13).

Гнездицкий В.В., Корепина О.С., Карлов В.А. и др. Компьютерная ЭЭГ и когнитивные вызванные потенциалы у пожилых и больных с афазией и эпилепсией после инсульта. Эпилепсия и пароксизмальные состояния. 2016. № 8(1). С. 12-21.

Daly D.D., Pedley T.A. Current practice of clinical electroencephalography: 2nd ed. New York, 1999.

Гнездицкий В.В., Корепина О.С. Атлас по вызванным потенциалам мозга: практическое руководство, основанное на анализе конкретных клинических наблюдений. Иваново: Изд.-полигр. комплекс «ПресСто», 2011. 532 с.

Генералов В.О., Садыков Т.Р., Мишнякова Л.П. Клинико-энцефалографические характеристики симптоматической эпилепсии у пациентов с хронической ишемией мозга. Практ. неврол. и нейрореабил. 2009. № 4. С. 29-33.

Кутан В.А. Компьютерная обработка энцефалограмм в клинике нервных болезней. Материалы науч.-практ. конф., посвящ. 130-летию Ивановской клинич. больницы. Иваново, 1991. С. 124-126.


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