Clinical Characteristics of Seizures and Epilepsy after Ischaemic Stroke

— Ischaemic stroke (IS) is a frequent cause of epilepsy.The aim of the study was to clarify the clinical features of post-stroke epilepsy (PSE). We examined 38 patients with epilepsy after IS: 10 women (26.3%) and 28 men (73.7%) aged from 28 to 74 years. Patient enrolment took place from 2017 to 2020. Epilepsy was diagnosed after one unprovoked seizure and if the risk of seizure recurrence was 60% or more in the subsequent 10 years, or if there were recurrent unprovoked seizures. Clinical interpretation of the seizures was based on the 2017 seizure classification. The efficacy of antiepileptic drugs was assessed based on seizure resolution criteria and presence of retractable epilepsy. Acute symptomatic seizures occurred in 5.3% of patients with PSE. Epilepsy onset consisted of a focal seizure in 60.5% of patients, an unknown onset generalized seizure in 26.3% of patients, while 13.2% had an unclassified seizure. Recurrent seizures were present in 63.2% of cases, seizures were controlled with antiepileptic therapy in 61% of subjects, remission was achieved without medication in 5.3% of subjects, 15.8% of cases had no change or a decrease in seizure frequency, while 3.8% of cases developed drug-resistant epilepsy. Recurrent unprovoked seizures are typical of post-stroke epilepsy, with a predominance of focal epileptic seizures and high efficacy of antiepileptic drugs.