Epilepsy as part of paroxysmal disorders after ischaemic stroke

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Abstract

Introduction. Epilepsy is a common cause of paroxysmal disorders appearing after ischaemic stroke.

The aim of the study was to clarify the clinical, neuroimaging, and neurophysiological features of post-stroke epilepsy (PSE).

Materials and methods. We examined 17 (81%) men and 4 (19%) women aged 25–89 years with paroxysmal disorders after ischaemic stroke. Fourteen (66.7%) patients were diagnosed with PSE, while 7 (33.3%) had non-epileptic paroxysmal disorders (NEPD). We conducted a comparative assessment of the groups, considering the clinical, neuroimaging, and 10-hour night-time video-EEG monitoring data.

Results. In patients with PSE, 64.8% of cases had total damage of the insular lobe, and infarcts more often included the cerebral cortex (100%) and white matter, as well as the basal nuclei and other deep brain structures. The EEG recorded epileptiform activity and/or hemispheric slowing on the side of the infarction (64.3%). In patients with NEPD, the infarct was more often located in the vertebrobasilar artery territory, and the paroxysmal disorders were recurrent.

Conclusion. Differential diagnosis of post-stroke paroxysmal disorders is based on the analysis of their clinical signs and medical history. In some cases, data from long-term video EEG monitoring are crucial for the diagnosis of PSE.

About the authors

Marina Yu. Maksimova

Research Center of Neurology

Author for correspondence.
Email: ncnmaximova@mail.ru
Russian Federation, Moscow

Amayak G. Brutian

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

Elena V. Shalimanova

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

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Copyright (c) 2020 Maksimova M.Y., Brutian A.G., Shalimanova E.V.

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