1. [Epileptic seizures and epilepsy after a stroke : Incidence, prevention and treatment].
- Author
-
Benninger F and Holtkamp M
- Subjects
- Acute Disease, Anticonvulsants therapeutic use, Cerebral Hemorrhage complications, Cerebral Infarction complications, Cross-Sectional Studies, Epilepsy prevention & control, Epilepsy therapy, Humans, Primary Prevention, Recurrence, Risk Factors, Secondary Prevention, Seizures prevention & control, Seizures therapy, Epilepsy epidemiology, Seizures epidemiology, Stroke complications
- Abstract
Following stroke, 3-6% of patients develop acute symptomatic seizures within the first 7 days. The rate is higher after cerebral haemorrhage compared to ischaemia. In 10-12% of patients, after more than 7 days unprovoked seizures occur. Due to these low incidence rates, primary prophylaxis with antiepileptic drugs is generally not necessary. Following one acute symptomatic seizure, recurrence risk within the first 7 days post-stroke is 10-20%, generally arguing against secondary prophylaxis with an antiepileptic drug. In clinical practice however, antiepileptic drug treatment in this constellation is often initiated. If this is done, the antiepileptic drug should be withdrawn soon after the acute phase, as the long-term risk for manifestation of an unprovoked seizure is approximately 30%. Following one post-stroke unprovoked seizure, recurrence risk within the next 10 years is more than 70%, this defines epilepsy. In this case, antiepileptic drug treatment is regularly recommended.
- Published
- 2017
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