There are two types of stroke: ischemic and hemorrhagic. Either type may cause seizures. Medical professionals refer to such seizures as “post-stroke seizures.”
Ischemic stroke occurs when a blockage within a blood vessel interrupts the blood supply to the brain. Hemorrhagic stroke occurs due to a bleed on or around the brain.
This article outlines the symptoms of stroke and why a person may experience seizures or epilepsy following a stroke. It also gives first-aid tips for seizures and explains the different types of seizures and associated symptoms alongside diagnosing and treating epilepsy.
- a sudden severe headache
- sudden vision problems in one or both eyes
- sudden weakness or numbness on one side of the face or body
- sudden confusion
- difficulty speaking or understanding speech
- balance issues
- lack of coordination
- sudden difficulty walking
A person can use the
- F — face: If they ask the person to smile, does one side of the face droop?
- A — arms: Can the person raise both arms, and does one arm drift downward?
- S — speech: If they ask the person to say something simple, does their speech sound slurred or unusual?
- T — time: If a person suspects someone may have had a stroke, they should call the emergency services immediately.
- severe stroke
- hemorrhagic stroke
- a stroke in the cerebral cortex of the brain
Post-stroke seizures are more likely to occur within the first
A 2015 meta-analysis found that post-stroke seizures occurred in 6.93% of people who had experienced a stroke. The study authors added that post-stroke seizures were more common among those who had experienced a hemorrhagic stroke or a stroke in the cerebral cortex.
Epilepsy is a neurological condition in which abnormal electrical activity in the brain results in recurrent seizures. According to the
The American Association of Neurological Surgeons (AANS) states that stroke is one cause of epilepsy in older people, with other possible causes including head trauma and brain tumors.
However, having post-stroke seizures does
According to a 2019 review, stroke accounts for approximately 11% of adult epilepsy cases and 45% of epilepsy cases in people over 60 years old.
Post-stroke seizures are partial seizures as they start in the area of the brain that a stroke damages.
- Simple focal seizures: These affect a small area of the brain. They may cause muscle twitches or changes in taste or smell.
- Complex focal seizures: These may confuse a person and leave them unable to answer questions or directions for several minutes.
- Secondary generalized seizures: These begin as a partial seizure in one area of the brain and progress to a generalized seizure affecting both sides of the brain.
When considering a diagnosis of epilepsy, a doctor will begin by taking a full medical history and asking questions about the person’s seizures. If the doctor suspects epilepsy, they may refer the person to a neurologist who specializes in conditions of the brain and nervous system.
For a person to receive the correct treatment, it is essential that the neurologist correctly identifies the form of epilepsy they have and the types of seizures they experience.
Antiepileptic drugs (AEDs) are the first-line treatment for epilepsy. These medications help prevent seizures by reducing excessive and confused electrical signaling between brain cells. According to the AANS, AEDs completely manage seizures in around 70% of cases.
There are various AEDs available. The right medication depends on the type of epilepsy a person has and the types of seizures they experience.
Other factors a doctor may take into consideration when prescribing AEDs include:
- medication costs
- other medications the person is currently taking
- previous or current medical conditions
- possible side effects
People who experience only one post-stroke seizure will usually not require treatment.
If a person witnesses another person having a seizure, they should stay with the person until the seizure is over. The person who witnessed the seizure
- Help the person to find a comfortable and safe place to sit.
- Speak calmly and use simple language to explain what happened.
- Check if the person is wearing a medical bracelet.
- Ensure the person gets home safely.
If a person is having a generalized tonic-clonic seizure, they may cry out, fall, lose consciousness, and have muscle spasms. In such cases, a person should follow the steps below:
- Help the person to the floor.
- Turn the person onto their side to assist with their breathing.
- Clear the area surrounding the person of anything hard or sharp that may cause injury.
- Place something soft and flat under the person’s head.
- Remove eyeglasses or sunglasses if the person is wearing them.
- Loosen anything around the person’s neck that may impair their breathing.
- Time the seizure.
- Call 911 if the seizure lasts more than 5 minutes.
Seizures do not always require medical intervention. However, a person should call 911 if it is the person’s first seizure or if the seizure lasts longer than 5 minutes.
A person should inform a doctor if they have had a seizure and should always tell them about any previous stroke.
Seizures may be
- memory issues
People should also inform a doctor if others tell them they have periods of “zoning out” or staring into space. These can also be signs of a seizure.
Following a stroke, some people go on to have one or more seizures. Medical professionals refer to such seizures as post-stroke seizures. A person who experiences two or more post-stroke seizures may receive a diagnosis of epilepsy.
A post-stroke seizure results from brain injury and associated abnormal electrical activity in the brain. Post-stroke seizures are more common following certain types of stroke, such as severe stroke, hemorrhagic stroke, or a stroke in the cerebral cortex of the brain.
A person who experiences only one post-stroke seizure may not require medication to control seizures. However, a person who develops epilepsy following a stroke may require antiepileptic drugs. A person can consult a doctor about their individual treatment options.