The Cortical Involvement of Territorial Infarcts as a Risk Factor for Stroke-Related Seizures

Abstract

Background: The cortical involvement of territorial infarcts is considered to be a significant risk factor for the development of early- as well as late-onset seizures. However, it is not known which cortical regions are more susceptible to the development of stroke-related seizures. Patients and Methods: In this retrospective study of 687 patients with territorial infarcts, 184 with stroke-related seizures were compared to 503 without seizures. The extent and the location of the infarcts were determined by computed tomography (CT) scans and/or magnetic resonance imaging (MRI) scans of the brain. The infarcts of the seizure and the non-seizure group were compared on digital cerebral vascular maps by superimposing the CT and/or MRI slices. Results: In patients with late-onset seizures, the infarcts were significantly more frequent in the temporal and parietal branches of the middle cerebral artery in comparison to the non-seizure group. In patients with early-onset seizures and in those with seizures due to a recurrent stroke, the territory of the temporal and occipital branches of the middle cerebral artery was the predilection side of the infarcts. Generalized tonic-clonic seizures occurred mainly in cases of infarction in the deep territory of the middle cerebral and of the anterior choroidal artery. Status epilepticus was significantly correlated with infarcts in the posterior temporal region. Conclusion: Some infarct regions are the sides of predilection for stroke-related seizures according to their type and their onset-time.

Risk Factors for Nonconvulsive Status Epilepticus after Stroke

“…After ischemic stroke, NCSE was more frequently observed in the anterior versus the posterior circulation infarct [14]. Although some reports have demonstrated a correlation between SE and lobar [6] or posterior temporal [22] lesions, other studies have reported finding no relationship between localization and the occurrence of SE [2,3,13]. Outcomes at discharge and the mortality rates were not significantly different between the CSE and NCSE groups.…”

A Case of First Epileptic Seizure Diagnosed with Top of the Basilar Syndrome

“…Early-onset stroke is more common in infarctions due to occlusion of anterior circulation than those originating from the posterior system [12]. The mechanism underlying seizure in patients with posterior system infarctions is unclear.…”

Cognitive Impairment and Seizures in Patients with Lacunar Strokes

“…26 Repeated seizures or epilepsy, following any kind of ischaemic stroke, leads to a significantly lower mean MMSE score. 27 also in patients with late-onset cryptogenic seizures positron emission tomography (PET) examination suggests that they could represent the premonitory signs of a progressive encephalopathy leading to cognitive impairment.…”