Clinical neurophysiology of acute symptomatic seizure in stroke patients

Matsubara Soichiro, Nakajima Makoto

doi:10.11422/jscn.50.84

<p>Patients with acute stroke sometimes develop epileptic seizures, which are recently called acute symptomatic seizures (ASS). ASS is quite important in two ways as follows. First, it could pathologically affect the brain condition after stroke, thereby worsening the functional outcome; second, ASS itself could be a risk for post-stroke epilepsy. Status epilepticus (SE) including nonconvulsive status epilepticus (NCSE) can be associated with clinical deterioration after acute stroke. Especially, although being easily overlooked, NCSE is not a rare complication in acute stroke. Prolonged SE including NCSE has also recently been reported to be a risk for development of epilepsy. Because poorly controlled SE can cause secondary brain damage, the importance of controlling this condition to improve the outcome of patients with neurological diseases, including stroke, is a focus of attention in the field of neurointensive care. Various observational studies have identified acute symptomatic seizures as a high-risk factor for developing epilepsy after stroke. Recently, high accuracy in prediction of developing epilepsy was reported in the SeLECT score for cerebral infarction and the CAVE score for cerebral hemorrhage. Early intervention to suppress epileptogenesis would be crucial to reduce the incidence of post-stroke epilepsy in high-risk patients identified based on these scores.</p>

Clinical neurophysiology of acute symptomatic seizure in stroke patients

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