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<p>Ischemic and hemorrhagic strokes are the most common etiologies of epilepsy in older adults. If an epileptic seizure occurs within the first 7&#xa0;days after a&#xa0;stroke, it is classified as acute symptomatic. Due to the low risk of subsequent unprovoked seizures, acute symptomatic seizures do not meet the definition of epilepsy, and antiseizure medication is not recommended. Epileptic seizures occurring &gt; 7&#xa0;days after a&#xa0;stroke are considered unprovoked seizures. With a&#xa0;recurrence risk &gt; 60% within the subsequent 10&#xa0;years, epilepsy is diagnosed in this context. Antiseizure medication should be initiated. Lamotrigine is the first-line agent of choice. When the underlying cause is an ischemic stroke, the seizure outcome is generally favorable. Since epileptic seizures may represent not only a&#xa0;consequence but also a&#xa0;precursor phenomenon of cerebrovascular events, screening for vascular risk factors is warranted in newly diagnosed epilepsy in older adults.</p>

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Epileptische Anfälle vor und nach Schlaganfällen

  • 期刊论文

  • 发表日期：

    2026年2月10日

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  • J. Dörrfuß,
  • T. Hüsing,
  • B. J. Vorderwülbecke,
  • M. Holtkamp

摘要

Ischemic and hemorrhagic strokes are the most common etiologies of epilepsy in older adults. If an epileptic seizure occurs within the first 7 days after a stroke, it is classified as acute symptomatic. Due to the low risk of subsequent unprovoked seizures, acute symptomatic seizures do not meet the definition of epilepsy, and antiseizure medication is not recommended. Epileptic seizures occurring > 7 days after a stroke are considered unprovoked seizures. With a recurrence risk > 60% within the subsequent 10 years, epilepsy is diagnosed in this context. Antiseizure medication should be initiated. Lamotrigine is the first-line agent of choice. When the underlying cause is an ischemic stroke, the seizure outcome is generally favorable. Since epileptic seizures may represent not only a consequence but also a precursor phenomenon of cerebrovascular events, screening for vascular risk factors is warranted in newly diagnosed epilepsy in older adults.