Abstract
The aim of the research: epilepsy on the background of ischemic stroke. Studied problem: improve of diagnosis of epilepsy on the background of ischemic stroke by establishing the clinical features of epileptic seizures and by detection of brain structural damages The main scientific results: a cross-sectional randomized cohort comparative study with retrospective and prospective stages was performed in 60 patients (men and women) with ischemic stroke aged 65 [57.0; 74.0] years, in 30 of which epileptic seizures were detected. The predominance of generalized single (66.7±38.5 %) variants was found in the structure of epileptic seizures in patients with acute cerebrovascular pathology. A higher frequency of generalized variants of seizures in patients over 60 years of age (maximum at 61–70 years, at descending – 71–80 years, over 80 years) has been revealed. The descending distribution of localization frequency of brain lesions (detected with MRI, CT) in patients with epileptic seizures after ischemic stroke is as follows: dilation of the subarachnoid space (93.3±24.1 %), dilation of the brain ventricles (83.3±34.0 %), subcortical ganglia (76.7±37.0 %), right hemisphere or temporal lobe (60.0±37.9 %), subcortex (56.7±37.3 %), frontal lobe (50.0±35.4 %), left hemisphere or diffuse-atrophic changes in the cortical region (43.3±32.6 %), temporal lobe (20.0±17.9 %), occipital lobe (16.7±15.2 %). The area of practical use of the research results: clinical medicine, especially neurology. Innovative technological product: methodology of diagnosis of epilepsy on the background of ischemic stroke. Scope of the innovative technological product: the evaluation of seizures and brain’s structural damages in patients with ischemic stroke with the development of epileptic seizures may be a means of improving the diagnosis of epilepsy on the background of cerebrovascular disease.
Highlights
IntroductionProblem description According to the clinical standard regulated by the International Antiepileptic League (ILAE), epilepsy is diagnosed on the basis of a set of parameters, including clinical symptoms, history, electroencephalography and imaging methods of brain examination [1, 2]
Studied problem: improve of diagnosis of epilepsy on the background of ischemic stroke by establishing the clinical features of epileptic seizures and by detection of brain structural damages The main scientific results: a cross-sectional randomized cohort comparative study with retrospective and prospective stages was performed in 60 patients with ischemic stroke aged 65 [57.0; 74.0] years, in 30 of which epileptic seizures were detected
The predominance of generalized single (66.7±38.5 %) variants was found in the structure of epileptic seizures in patients with acute cerebrovascular pathology
Summary
Problem description According to the clinical standard regulated by the International Antiepileptic League (ILAE), epilepsy is diagnosed on the basis of a set of parameters, including clinical symptoms, history, electroencephalography and imaging methods of brain examination [1, 2]. Unlike early post-stroke seizures, which most often occur during a patient’s stay in the hospital, late seizures are more difficult to diagnose because their symptoms are often ignored or hidden in patients with severe neurological deficits after stroke. Diagnosis is facilitated if other people were present at the time of the attack or the patient witnessed a typical clinical picture characterized by focal or generalized seizures and impaired consciousness. Often patients may not have any focal motor or sensory signs, but only slightly altered behaviour and mental status [3]
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