DOI: https://doi.org/10.22141/2224-0713.16.1.2020.197334

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

Abstract


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.

Keywords


post-stroke epilepsy; ischemic stroke; encephalography; review

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