Some clinical and diagnostic features of patients with new-onset epilepsy in the presence of chronic cerebrovascular disease

Abstract

Objective : to investigate the specific features of epilepsy that manifests itself in the presence of chronic cerebrovascular disease. Patients and methods. A total of 304 patients (a study group of 174 patients with new-onset seizures developing in the presence of cerebrovascular disease and a control group of 130 patients with cerebrovascular disease and no seizures) were examined. They underwent clinical neurological examination, electroencephalography (EEG), ultrasonic duplex scanning of extra- and intracranial arteries with functional tests, and visualization of brain structures. Results. Focal seizures were prevalent in the patients with cerebrovascular disease and epilepsy. It was found that there was a preponderance of left-sided localization of EEG foci of abnormal activity and a tendency to more commonly detect subcritical and critical stenoses in the left carotid bed in the patients with epileptic seizures. Diminished perfusion reserves in the posterior circulation system were more frequently observed in the patients with seizures in the presence of cardiovascular diseases. Moreover, the patients with seizures displayed a more profound degree of brain ischemia with the frequent cortical and subcortical localization of dyscirculatory foci. Thus, a study of perfusion reserves, localization of vascular foci, and degree of occlusive changes in the wall of brachiocephalic vessels allows identification of risk factors for epilepsy in the patients with cerebrovascular disease and promotes the prediction of the course of the disease.