REVIEW – January 2023

Post-stroke management of epileptic seizures and epilepsy

Authors: Britta-Mai Nõmmik, Janika Kõrv, Aleksei Rakitin

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Post-stroke epilepsy is a common complication after stroke and requires appropriate management and support in long term.
Certain factors as intracerebral haemorrhage, cortical involvement, severity of initial neurological deficit, younger patients (<65 years of age), carry a higher risk of post-stroke epilepsy.
It is essential for anyone involved in the treatment of patients with seizures and stroke to differentiate between acute symptomatic seizures, occurring within seven days from stroke onset, and unprovoked seizures occurring later.
Due to high seizure recurrence rate, appropriate antiseizure medication should be started after a single late post-stroke
seizure. Further research and investigations are needed to solve several issues in post-stroke epilepsy management, which have remained open.