THE PHENOMENOLOGY OF SEIZURES AND EPILEPSY AFTER STROKE

Epilepsy and stroke continue to be cast in the spotlight of the public health arena as major causes of mortality and morbidity. Our understa nding of these two disease processes has surged in recent years with m any advances in diagnostic modalities and treatment strategies. Less u nderstood is the relationship of seizures and epilepsy as they occur i n the setting of stroke. Several studies have been published that exam ine the association between stroke and the ensuing seizure entity they create. However, in many of these investigations the conclusions reac hed have been variable. In this paper the authors have attempted to pr esent a compilation of the work carried out to date on this subject. T he topics addressed include the incidence of seizures and epilepsy aft er stroke and the factors that influence them, such as location, size, and type of stroke. The latency of seizures after stroke and their re lationship to stroke location, risk of recurrent seizures, and subsequ ent mortality and morbidity are also presented. Other topics covered i nclude the possible pathophysiologic mechanisms at play, the predictiv e value of electroencephalographic studies, and anticonvulsant treatme nt strategies. Finally, two instructive case reports have been include d to further illustrate the relationship between seizures and stroke. (C) 1998 by Elsevier Science Inc. All rights reserved.