Epilepsy after Ischemic Stroke: Does it Make Sense to Prescribe Anticonvulsants after the First Attack?

N.V. Sofilkanych, M.M. Oros, V.I. Smolanka, V.V. Luts

Abstract


Background. The incidence of epileptic attacks in patients, who suffered a stroke, ranges widely — from 3 to more than 60 % [8, 11–15]. Today, many aspects of this problem in post-stroke epilepsy haven’t been completely studied, including the problem of the time for administering antiepileptic preparations. The aim of investigation — to define the prognosis of symptomatic epilepsy development after the stroke depending on the intake of anticonvulsants by patients after the first epileptic attack. Materials and methods. We made a complex examination of 1,012 patients (562 males and 450 females) aged 49 to 90 years, who had suffered an ischemic stroke during 2011–2014. While analyzing the state of all these 1,012 patients, it was revealed that within 6 months after the ischemic stroke at least 1 epileptic attack was observed in 151 patients. According to the type of attacks, focal ones (80.9 %, p < 0.001) prevailed, and only in 11.1 % of patients primary generalized epileptic seizures were diagnosed. Results and discussion. In order to compare the state of stroke patients after the first epileptic attack, we took similar groups: the first one (n = 81) and the second one (n = 80). In the first group, we administered antiepileptic preparations after the first epileptic attack, and no preparation in the second one. The patients’ condition was evaluated 1 year after the first epileptic seizure. The criteria for evaluation were: the presence of one or more epileptic attack, i.e. the diagnosis of symptomatic post-stroke epilepsy, or complete absence of any epileptic seizure. According to the results of observation, in the first group of patients, who took anticonvulsants, during one year repeated epileptic attacks were detected in 28 patients, which made up 27.1 %, while in the other group, where there was no treatment with anticonvulsants, during a year recurrent seizures were observed in 43 patients, which made up 53.75 %. Conclusion. These results are the basis for further investigations and possible recommendation to administer antiepileptic preparations just after the first epileptic attack in the patients, who have suffered a stroke.


Keywords


epilepsy; stroke; anticonvulsants

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DOI: https://doi.org/10.22141/2224-0713.4.82.2016.77697

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