Épilepsie et accident vasculaire cérébral

Stroke is associated with an increased risk of subsequent seizures and epilepsy. Cerebrovascular lesions are the leading cause of epilepsy in the elderly, ahead of degenerative disorders, brain tumors and head trauma, accounting for up to one-third of newly diagnosed seizures in this population. The frequency of seizures in stroke victims varies from 5 to 20%, but only a minority will develop epilepsy. Based on differences in their presumed pathophysiology, seizures after stroke are usually divided into early and late seizures, according to various definitions. Early seizures are usually defined as those occurring within one or two weeks after stroke; late seizures usually occur within the first year after stroke. Several risk factors of seizures have been identified; stroke subtype and cortical location being the best-characterized predictors of seizure development. The optimal timing and type of anti-epileptic treatment remain debated. Several findings suggest that the majority of first generation anti-epileptic drugs are not the best choice in stroke patients.