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Open Access

Poststroke seizure: optimising its management

Michael Y Xu
DOI: 10.1136/svn-2018-000175 Published 25 March 2019
Michael Y Xu
Department of Neurology, OSF Illinois Neurological Institute, University of Illinois College of Medicine, Peoria, Illinois, USA
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    Figure 1

    Lateralised periodic discharges (LPDs, formerly known as periodic lateralised epileptiform discharges). The EEG showed left side LPDs recurring at 0.5 Hz (discharges per second) with focal slowing in the same area. This EEG was obtained from a 61-year-old woman with left middle cerebral artery infarct and one-time generalised tonic-clonic seizure.

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    Figure 2

    Bilateral independent periodic discharges (BIPDs, formerly known as bilateral independent periodic lateralised epileptiform discharges). The electroencephalogram (EEG) showed BIPDs are present over the bilateral temporal areas independently (unsynchronised). This EEG was obtained from a 34-year-old man with subarachnoid haemorrhage and several generalised tonic-clonic seizures.

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    Figure 3

    Lateralised intermittent rhythmic delta activity. The electroencephalogram (EEG) showed left side (mainly left temporal lobe) brief intermittent runs of rhythmic delta activity at 1–1.5 Hz. This EEG was obtained from a 65-year-old woman with 1-year history left side middle cerebral artery stroke and intermittent altered mental status and aphasia.

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  • Table 1

    Seven items of the Post-Stroke Epilepsy Risk Scale

    ItemWeight
    Supratentorial stroke2
    ICH involving cortical areas2
    Ischaemia involving cortical or cortical-subcortical areas1
    Ischaemia + ongoing neurological deficit1
    Stroke caused neurological deficit with mRS > 3
    Seizure occurred up to 14 days after stroke1
    Seizure occurred 15 days or later after stroke2
    • ICH, intracerebral haemorrhage; mRS, modified Rankin scale.

  • Table 2

    CAVE score (for LS from ICH)

    CAVERisk of LS
    C: cortical involvement (1 point)0 point: 0.6%
    A: age <65 years (1 point)1 point: 3.6%
    V: volume >10 mL (1 point)2 points: 9.8%
    E: early seizure (1 point)3 points: 34.8%
    4 points: 46.2%
    • ICH, intracerebral haemorrhage; LS, late seizure.

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Vol 4 Issue 1 Table of Contents
Stroke and Vascular Neurology: 4 (1)
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Poststroke seizure: optimising its management
Michael Y Xu
Stroke and Vascular Neurology Mar 2019, 4 (1) 48-56; DOI: 10.1136/svn-2018-000175

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Poststroke seizure: optimising its management
Michael Y Xu
Stroke and Vascular Neurology Mar 2019, 4 (1) 48-56; DOI: 10.1136/svn-2018-000175
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Poststroke seizure: optimising its management
Michael Y Xu
Stroke and Vascular Neurology Mar 2019, 4 (1) 48-56; DOI: 10.1136/svn-2018-000175
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