Re: Stroke and related residual effects, seizure disorder
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Posted by CCF Neuro MD on July 19, 1997 at 23:01:02:
In Reply to: Stroke and related residual effects, seizure disorder posted by Deborah Parsons on July 09, 1997 at 14:55:15:
I am interested in information about post stroke seizure disorder treatment and control, as well as definitions and descriptions of diagnostic techniques.
In general, convulsive seizures are relatively uncommon in the evolving phases of a stroke. Only a very small persent of patients experience seisure right after a stroke. As shown in a recent study by Mayo Clinic, early seisure occured in 6% post stroke patients, and late seisure in little more than 5% patients.
As far as the management, they should be treated as fully developed seisures in nonstroke patients, but with greater caution. Post stroke patients tend to have residual motor and sensory deficits. They are not able to detect and report the early symptoms of seisures and take save actions accordingly. Therefore, their seisures can cause severe physical damage and trauma. On the other hand, the clinical presentation of seisures may be less typical than in someone who did not have a stroke. This may make the clinical diagnosis more difficult. The standard diagnostic tool is a brain wave testing call EEG which can demonstrate abnormal focal electric discharge in 30-50% cases after a seisure. Anticonvalsents (anti-seisure medication) (ACDs) are generally started in a patient with a typical clinical presentation with or without EEG corelation. Since most of post stroke patients are on multiple drugs, and some are on blood thinners (such as coumadin), it is very important to watch blood parameters for both ACDs and other meds, because they interfere with each other and alter the serum concentrations of each other.
Therefore, as you can see, the diagnosis and management of post stroke seisures can be a real challenge. The best way to handle this problem is to be evaluated and followed by a neurologist, preferrably a stroke specialist. This can be acomplished at your neurologist's office, or if you prefer, at our department. As you probably know, our stroke center, led by Dr. Anthony Furlan, is one of the biggest and the most experienced in the nation. Feel free to call toll free at (800) 223-2273 ext. 45559 or (216)444-5559 locally for an appointment at your convenience.
This information is provided for general medical education purposes only. Please consult your physician for the diagnosis and treatment of your specific medical condition.
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