Medical Management of Seizures in Cerebrovascular Disorders



Management of seizures and epilepsy in persons who have had a cerebrovascular accident is a complex process involving a number of decisions. Was the event in question an epileptic seizure? If so, should treatment be initiated after a single seizure? If treatment is considered necessary, which antiepileptic drug (AED) should be used to prevent seizure recurrence?

Seizures may present in different settings. Some seizures present in the acute phase of a cerebrovascular accident, often when the patient is in the intensive care unit. Others present weeks or months after a stroke, in which case the recurrence rate is high if untreated, often leading to the diagnosis of epilepsy, rather than single seizures. The pathophysiology, treatment modalities, and consequences of acute poststroke events differ greatly from late seizures and are discussed separately in this chapter. In addition, we discuss the challenges associated with management of seizures and epilepsy in the elderly (Leppik, Walczak, Birnbaum, Lancet, 380:1128–1130, 2012).


Seizure Antiepileptic drugs Clinical trials Drug interaction 


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of NeurologyThe George Washington Medical Faculty AssociatesWashingtonUSA
  2. 2.Department of Neurology & PharmacyUniversity of MinnesotaMinneapolisUSA

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