STROKE

Seizures

Focal seizures are usually the initial seizure type, with features referable to the location of the stroke.

Focal to bilateral tonic-clonic seizures can occur, these may have focal features referable to the location of the stroke if this information is carefully sought.

Status epilepticus, including focal status epilepticus, can occur.

CAUTION patients with stroke in early life, who have earlier age of seizure onset, may have a change in their seizure types over time, with the emergence of epileptic spasms or generalized seizure types, such as atypical absence, atonic and tonic seizures. Developmental and cognitive impairments are more common in this group. If these seizure types are seen, achieving full seizure control is important, if this is not achieved with medication, epilepsy surgery should be considered.

CAUTION seizures in neonates and young infants with stroke may be subtle clinically, and may require EEG surveillance for detection or confirmation.