Early and Late Onset Seizures After Cerebrovascular Disease

Abstract

Objectives:This study aimed to compare seizure types, clinical and demographic features, treatment response and prognosis among patients with early and late onset post-stroke seizures.Methods:A retrospective evaluation was made of the data of 46 patients admitted to our clinic between January 2000 and April 2006 diagnosed with cerebrovascular disease, and who had post-stroke epileptic seizures. Two types of post-stroke seizures were defined; ‘early onset’ (occurring within 14 days post-stroke) and ‘late onset’ (occurring after the 14th day).Results:Among the 46 patients, 15 (32.6%) had early onset and 31 (67.3%) had late onset seizures. The early onset post-stroke seizures occurred more frequently after hemorrhagic stroke, while the late onset were more often seen in ischemic stroke. Ischemic strokes occurred mostly in the middle cerebral artery area, whereas lobar cortical hematomas were observed in the hemorrhagic stroke patients. The early onset seizures had statistically significant left hemisphere lesions, while those which were late onset had right hemisphere lesions (p<0.038). Secondary generalized seizures were the most common type in both groups. The seizures were well controlled with monotherapy in both groups, but seizure recurrence was found to be higher in the late onset seizure group.Conclusion:This study found significant left hemisphere lesions in the patients with early onset seizures, while in those with late onset seizures, lesions were present in the right hemisphere. In both groups, cortical involvement played an important role. Secondary generalized seizures were the most frequently occurring, and these were treated with antiepileptic monotherapy.

Keywords

• early onset seizures
• late onset seizures
• cerebrovascular disease