engleski

Cerebrovascular disease as a cause of epileptic syndrome

The study included patients admitted to the Department during a three-year period (1993-1995) with a diagnosis of epileptic syndrome, in whom the seizures were found to be due to cerebrovascular disease. There were 49 (35%) such patients out of the total of 139 emergency admissions with the diagnosis of epilepsy. According to the type of epilepsy the most common type was grand mal, found in 23 (47%) patients, followed by jacksonian motor epilepsy in 8 (16%), jacksonian motor epilepsy with secondary generalisation in 11 (23%), Koshevnikoffs epilepsy in two, partial complex seizures with motor automatismus in one, recurrent serial grand mal seizures in three, and grand mal status in one patient. In 20 patients, only one seizure was recorded, whereas recurrent seizures occurred in 29 patients. Three patients with ischemic stroke had � precursor seizures� , whereas initial epilepsy at the seizure onset was recorded in 20 patients (four cases of transient ischemic attack., 10 cases of ischemic and five cases of hemorrhagic stroke, and one case of subara-chnoid hemorrhagic stroke, and one case of subarachnoid hemorrhage) . In six patients, recurrent epileptic seizures occurred within a month from tile initial stroke. Early epilepsy after stroke was recorded within 1-6 months in five patients, always after the onset of ischemic stroke. Late postepiplectic, "cicatricial'' epilepsy was also found to mostly occur secondary to ischemic ; and less commonly after hemorrhagic stroke . In the diagnosis of stroke and concurrent epilepsy, results of the following examinations were used in addition to clinical data: EEG in 35, brain scintigraphy in seven, brain CT ill 37 and angiography 111 one case. Similar to other studies, our results also showed the epilepsy syndrome in stroke patients to most commonly develop on the epileptogenic focus formed by the mechanisms of ischemia. In its acute phase, it may also frequently occur in hemorrhagic stroke and subarachnoid hemorrhage. Accurate diagnosis can be made in a great number of emergency cases, even in the conditions of relatively inadequate equipment.

cerebrovascular disease; stroke; epileptic syndrome

nije evidentirano