Frequancy of early and late onset seizures after cerebrovascular disease

Introduction: Cerebrovascular diseases have an important role in the pathogenesis of symptomatic epilepsy, especially in older age. In this study, we aimed to evaluate frequency and prognosis of early and late onset seizures after cerebrovascular disease.Material and Method: In this retrospective study, 1789 patients? who were diagnosed with acute cerebrovascular disease Neurology archive files have been scanned and 188 patients who have seizures were taken to study. History, personal profil, demographic caracteristics, neurological examination findings, age at stroke, stroke type and etiology, lateralization of stroke according to MRG or CT scan, topographic evaluation of the lesions, EEG findings, seizure onset, seizure type and frequency, antiepileptic treatment, prognosis after treatment data from archive files was recorded. Stroke types were classified to ischemic and hemorrhagic stroke. Subtypes of ischemic stroke evaluated according to TOAST classification. Patients who had seizures after stroke, including early and late seizure group were divided into 2 groups. The patients who had seizure at first 15 days after stroke were considered as early-onset seizure, the patients who had seizure after 16. day were considered as late-onset seizure group. Early and late seizure grups, frequency, age and sex, stroke type and etiology, neuroradiological findings, EEG findings, antiepileptic treatment and prognosis after treatment were compared.Subject: Frequency of seizures after stroke was found 10.5 %. The frequency of early-onset seizures after stroke was 5.1 %, late-onset seizure frequency was 5.4 %. Frequency of seizures after ischemic stroke was 9.6 %, frequency of seizures after hemorrhagic stroke was found 14.2 %. Early-onset seizure frequency was 4.6 % after ischemic stroke, 7.1 % after hemorrhagic stroke; late-onset seizure frequency was 5.0 % after ischemic stroke, 7.1 % after hemorrhagic stroke. 46 (56.1 %) female patients at an early stage, 36 (43.9 %) female patients late, 45 (42.5 %) male patients at an early stage, 61 (57.5 %) male patients, seizures began in later periods. Most frequently etiology of ischemic stroke was large arterial atherosclerosis for early-onset (26.3 %) and late-onset seizures (27.2 %). Right hemisphere involvement was more frequently for early-onset seizures (42.9 %), left hemisphere involvement was more frequently for late-onset seizures (51.5 %). Lobar involvement was 91,4 %, MCA involvement was detected 62.7 %. Seventeen patients (9.5 %) were diagnosed status epilepticus. Thirteen of them (76.4 %) were in early-onset seizure group. The seizures were totally or partially controlled in 90.5 % of the patients with monotherapy.Results: Seizures after stroke is most frequently in adult population older than 60 years and usually be controlled by antiepileptic monotherapy. Relatively late-onset seizures after stroke are more common. Early and late-onset seizures after stroke are more common in hemorrhagic stroke. Lobar-multilobar, unilateral, supratentorial, anterior circulation and MCA involvement are the risk factors for early and late-onset seizures after stroke and these are same for two groups.