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We retrospectively studied 90 patients with postinfarction seizures to determine the clinical features(onset,number,type),prognosis,and electroencephalographic and computed tomographic findings;we included infarctions of all etiologies.Thirty-three percent of the 90 seizures appeared early(within 2 weeks after the infarction),and 90%of the 30 early seizures appeared within 24 hours after the infarction.Seventy-three percent of the 90 seizures occurred within the first year,and only 2% occurred>2 years after the infarction.Fifty-six percent of the 90 seizures were single,and status epilepticus was seen in only 8%.Early-onset seizures were more likely to be partial(57%of 30);late-onset seizures were more likely to be generalized(65%of 60).Thirty-nine percent of the 90 initial seizures recurred and there was no significant difference in recurrence rate between early-or late-onset initial seizures.Twenty-two percent of the 90 initial seizures became multiple recurrent seizures,and we could identify a precipitating factor in 86%of the 35 recurrent seizures.The most common electroencephalographic abnormality in the 61 patients so examined was focal slowing(61%),but recurrent seizures occurred in 100%of the four patients with periodic lateralized epileptiform discharges and in 75%of the eight patients with diffuse slowing.Computed tomography in 61 patients showed that large infarctions were associated with early(n<0.021)and multiple(p<0.05)seizures.Deep infarctions on computed tomograms(cortical infarctions extending to subcortical structures)tended to cause recurrent seizures(p<0.057). Seizures in 88%of the 90 patients could be managed with monotherapy. |
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CAT scan
CAT scan,abnormal
cerebral infarction
cerebrovascular accident
cerebrovascular accident,seizure with
electroencephalogram
electroencephalogram,abnormalities of
prognosis
seizure
status epilepticus
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