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Current Neuropharmacology

Editor-in-Chief

ISSN (Print): 1570-159X
ISSN (Online): 1875-6190

Review Article

Epilepsy in Cerebrovascular Diseases: A Narrative Review

Author(s): Sabrina Neri, Sara Gasparini, Angelo Pascarella, Domenico Santangelo, Vittoria Cianci, Anna Mammì, Michele Lo Giudice, Edoardo Ferlazzo and Umberto Aguglia*

Volume 21, Issue 8, 2023

Published on: 02 February, 2023

Page: [1634 - 1645] Pages: 12

DOI: 10.2174/1570159X20666220706113925

Price: $65

Abstract

Background: Epilepsy is a common comorbidity of cerebrovascular disease and an increasing socioeconomic burden.

Objective: We aimed to provide an updated comprehensive review on the state of the art about seizures and epilepsy in stroke, cerebral haemorrhage, and leukoaraiosis.

Methods: We selected English-written articles on epilepsy, stroke, and small vessel disease up until December 2021. We reported the most recent data about epidemiology, pathophysiology, prognosis, and management for each disease.

Results: The main predictors for both ES and PSE are the severity and extent of stroke, the presence of cortical involvement and hemorrhagic transformation, while PSE is also predicted by younger age at stroke onset. Few data exist on physiopathology and seizure semiology, and no randomized controlled trial has been performed to standardize the therapeutic approach to post-stroke epilepsy.

Conclusion: Some aspects of ES and PSE have been well explored, particularly epidemiology and risk factors. On the contrary, few data exist on physiopathology, and existing evidence is mainly based on studies on animal models. Little is also known about seizure semiology, which may also be difficult to interpret by non-epileptologists. Moreover, the therapeutic approach needs standardization as regards indications and the choice of specific ASMs. Future research may help to better elucidate these aspects.

Keywords: seizures, epilepsy, cerebrovascular disease, stroke, post-stroke epilepsy, cerebral haemorrhage, leukoaraiosis

Graphical Abstract

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