Werhan, Conrad “Epilepsy in the Elderly" Dtsch Arztebl Int

Etiology of Epilepsy in Asia In Japan, Patients with late onset (50 years or older) no family history; half had a past history of cerebrovascular accident or head injury as a presumed etiology Lim, Shih-Hui “Epidemiology and Etiology of seizures and epilepsy in the elderly of Asia" Neurology Asia 2004; 9 (1): 31-32

Post Stroke Seizure Early Onset (Less than 2 weeks) Accumulation of intracellular calcium and sodium may result in depolarization of the transmembrane potential Increased extracellular glutamate Late Onset (Greater than 2 weeks) Persistent changes in neuronal excitability Replacement of healthy cell paranchyma by neuroglia and immune cells Silverman, Isaac, Restrepo, Lucas, Matthews, Gregory “Post-stroke Seizures." Archive of Neurology . 2002; 59: 195-202

Post Stroke Seizure Ischemic Stroke Hemorrhagic Stroke 35% of early onset seizure develop into epilepsy 90% of late onset seizure develop into epilepsy Hemorrhagic Stroke 29% of early onset seizure develop into epilepsy 93% of late onset seizure develop into epilepsy Silverman, Isaac, Restrepo, Lucas, Matthews, Gregory “Post-stroke Seizures." Archive of Neurology . 2002; 59: 195-202

Seizure After Stroke Study Seizures occurred in 168 (8.9%) of 1897 patients with stroke 28 [10.6%] of 265 with hemorrhagic 140 [8.6%] of 1632 with ischemic Risk factors for seizures after ischemic stroke Cortical location of infarction (HR, 2.09; 95% CI, 1.19-3.68; P,.01) Stroke disability (HR, 2.10; 95% CI, 1.16-3.82; P,.02) Risk factor for seizures after hemorrhagic stroke Cortical location (HR, 3.16; 95% CI, 1.35-7.40; P,.008). Post stroke epilepsy occurred in 47 (2.5%) of 1897 patients. Late onset of the first seizure was an independent risk factor for epilepsy after ischemic stroke (HR, 12.37; 95% CI, 4.74-32.32; P,.001) Bladin, Christopher, Alexandrov, Andrei, Bellavance Andre and et al “Sezures after Sroke: A Prospective Multicenter Study" Archive of Neurology. 2000; 57: 1617-1622