Epilepsy is one of the most actual social problems in modern neurology and psychiatry. According to the results of the domestic and foreign studies, the risk of developing epilepsy increases with age. The increased rate of nervous system vascular and degenerative diseases as well as brain tumors and head injuries in elderly patients is one of the reasons for it. The review is devoted to the development of epilepsy in adults having an active cerebrovascular disease. Epilepsy is the disease with multiple causative factors. Among the etiological factors of epilepsy development in adults, the predominant place belongs to vascular diseases. The article presents the epidemiological aspects of the problem, the questions of pathophysiology, the variability of epileptic syndromes developing as a result of ischemic brain disease. It describes the characteristics of epileptic process as a result of a vascular lesion. The role of the cerebrovascular reactivity in brain vascular diseases development is described. A place of different research methods (such as electroencephalography, transcranial and extracranial duplex ultrasonography scanning of the major brain vessels, different modes of magnetic resonance imaging, functional magnetic resonance imaging and magnetic resonance spectroscopy) in identifying risk factors for seizures in patients with cerebrovascular pathology is reported. Possible exogenous and endogenous precipitants (cerebral atherosclerotic vascular disease, hypertension, cerebrovascular deregulation, increased convulsive predisposition, the external epileptic triggers, etc.) are described.
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