Epilepsy after ishemic stroke: is it worth administering anticonvulsants after the first attack?

Abstract

Introduction: Epileptic attacks frequency in patients after stroke ranges widely from 3 % up to 60 %. Today many aspects of this problem in post-stroke epilepsy haven’t been completely studied, regarding the problem of the time for administering antiepileptic drugs (AEDs). The aim of this study was to define the prognosis of symptomatic epilepsy development after stroke depending on the patients taking AEDs after the first epileptic attack. Materials and methods: We perform a complex examination of 1012 patients (562 males and 450 females) aged from 49 up to 90 who had suffered from ischemic stroke during 2011-2014. Neurologic examinations were carried out according to the conventional methods scaling score NIHSS (National Institute of Health Scale of Stroke Severity, USA). Results: It was revealed that within 6 months after the ischemic stroke at least one epileptic attack was observed in 151 patients. According to the type of attacks focal attacks (80.9%, p<0.001) prevailed, and only in 11.1% initially generalized epileptic attacks were diagnosed. In the first patients group who took anticonvulsants during one year repeated epileptic attacks were revealed in 27.1% of patients while in the other group where there was no treatment with anticonvulsants during a year repeated attacks were observed in 53.75% patients. Conclusions: Obtained results are the basis for further investigations and possible recommended administration of AEDs just after the first epileptic attack in the patients after stroke.