Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector67810.25692/ACEN.2020.3.2Original articlesОригинальные статьиUnknownEpilepsy as part of paroxysmal disorders after ischaemic strokeЭпилепсия в структуре пароксизмальных состояний после ишемического инсультаMaksimovaMarina Yu.МаксимоваМарина Юрьевна
Russian Federation
ncnmaximova@mail.ruBrutianAmayak G.БрутянАмаяк Грачевич
Russian Federation
ncnmaximova@mail.ruShalimanovaElena V.ШалимановаЕлена Витальевна
Russian Federation
ncnmaximova@mail.ruResearch Center of NeurologyФГБНУ «Научный центр неврологии»14092020143112014092020Copyright ©; 2020, Maksimova M.Y., Brutian A.G., Shalimanova E.V.Copyright ©; 2020, Maksimova M.Y., Brutian A.G., Shalimanova E.V.2020Maksimova M.Y., Brutian A.G., Shalimanova E.V.Maksimova M.Y., Brutian A.G., Shalimanova E.V.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/678

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.

Введение. Эпилепсия является частой причиной пароксизмальных состояний, возникающих после ишемического инсульта.

Цель исследования — уточнить клинические, нейровизуализационные и нейрофизиологические особенности постинсультной эпилепсии (ПИЭ).

Материалы и методы. Обследованы 17 (81%) мужчин и 4 (19%) женщины в возрасте 25–89 лет с пароксизмальными состояниями, возникшими после ишемического инсульта. У 14 (66,7%) пациентов диагностирована ПИЭ, у 7 (33,3%) — пароксизмальные состояния неэпилептического генеза. Сопоставительная оценка групп проводилась с учетом клинических данных, данных нейровизуализации и 10-часового ночного видеоэлектроэнцефалографического мониторинга.

Результаты. У пациентов с ПИЭ в 64,8% случаев выявлено тотальное поражение островковой доли, инфаркты чаще захватывают кору (100%) и белое вещество полушария мозга, а также базальные ядра и другие глубинные структуры мозга, при ЭЭГ регистрировалась эпилептиформная активность и/или полушарное замедление на стороне инфаркта (64,3%). У пациентов с пароксизмальными состояниями неэпилептического генеза инсульт чаще развивался в бассейне артерий вертебробазилярной системы, пароксизмальные состояния являлись повторными.

Заключение. Дифференциальная диагностика пароксизмальных состояний, возникающих после инсульта, основывается на анализе их клинических проявлений и анамнезе. Данные длительного видео-электроэнцефалографического мониторинга в ряде случаев имеют решающее значение в диагностике ПИЭ.

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