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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Stroke and SeizureForum: Neurology Forum
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Re: Stroke and SeizurePosted by ccf neuro M.D. on April 14, 1997 at 22:31:27: In Reply to: Stroke and Seizure posted by Richard Wagner on April 09, 1997 at 12:38:16:
: My mother (age 81) suffered a stroke in mid December that affected her left side. After rehab she went home, but last Sunday she suffered from seizures that began on the left side and soon enveloped her whole body. She was placed in critical care, and is being watched closely. can you give me more information about seizures and strokes, and how they can be controlled? Thank you. = A stroke occurs when an artery within the brain gets clotted off, causing an area of the brain that the artery supplies blood to to die, which results in paralysis, loss of sensation, loss of vision, or problems with speech and language (usually only left side of brain strokes do this). Seizures are the result of abnormally excitable nerve cells in the brain that discharge abnormally. Seizures that remain confined to a specific part of the brain are called FOCAL, and often cause jerking of one side or part of the body. Those that spread all over the brain are called generalized, or so-called "grand mal" seizures. These seizures result in loss of consciousness of the patient and are dangerous if they occur repeatedly in a short interval of time without being treated. Strokes and seizures occasionally occur together because the stroke, while destroying a particular area of brain, often injures without permanently destroying another area of the brain that is at the margins of the area of the brain that suffered the stroke. Scarring, and irritation of the nerve cells in this part of the brain, often predisposes it to generating seizures. These are typically FOCAL seizures that are very resistant to treatment, but they may generalize to other parts of the brain if an anticonvulsant medication is not administered to prevent such spread. Attempting to suppress the smaller, focal seizures is usually a futile effort, and often as much or more harm results from the treatment efforts than from the small (focal) seizures themselves. There are many effective drugs that suppress generalizatiion or secondary spread of the small, focal seizures. Some examples include Dilantin or phenytoin, Tegretol or carbemazepine, and phenobarbitol (less often used than the other two. Another drug called Depakote or valproic acid is a fourth option. As long as the generalized seizures are controlled in your mother and as long as there has not been a NEW stroke that caused the seizures to erupt, your mother will probably gradually get back to where she was prior to reentering the hospital, provided the seizures were not prolonged and/or repetitive.
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