Stroke and Epilepsy: Critical Review of the Literature

Stroke-associated seizures and epilepsy provide an excellent clinical model to study both acute hyperexcitability after stroke and long-term tissue changes responsible for epileptogenic scar formation. The authors critically review the literature regarding stroke and seizures, to define the clinical spectrum of the association between stroke and seizures. Unfortunately, most of the studies performed in the past were either retrospective and heterogeneous or not designed to address this important issue. Constant improvements and advances in technology, including computerized tomography, magnetic resonance imaging, cerebral angiography and ultrasound, have made possible increasing sophistication in our investigation of patients with stroke and stroke-related seizures and emphasize the need for reassessment of this relationship. Part I gives an overview of the incidence of stroke-associated seizures, their phenomenology and dynamics, and attempts to identify specific risk factors for this association such as stroke subtypes starting with hemorrhagic conditions.