Rome, December 17, 2024 – Stroke is one of the leading causes of epilepsy in individuals over the age of 60. Scientific evidence highlights that stroke accounts for around 40% of epileptic seizures in this age group, underlining the intricate relationship between these two neurological conditions.
Epileptic seizures following a stroke are classified as early-onset and late-onset. Early-onset seizures occur within the first week of a stroke, often due to immediate changes in brain tissue, and generally do not require prophylaxis. On the other hand, late-onset seizures, which develop months or even years after the stroke, indicate epileptogenesis caused by residual brain “scarring”. These seizures require careful evaluation and appropriate treatment by a neurologist.
Risk factors and clinical management
According to Massimo Del Sette, Director of Neurology at Policlinico San Martino I.R.C.C.S. in Genoa, certain types of strokes pose a higher risk of epileptic seizures. These include cerebral hemorrhages, large-scale strokes, pre-existing cognitive decline, and concurrent conditions like infections. Managing these cases necessitates a collaborative approach between neurologists and epileptologists to select the most suitable anti-seizure medications.
“Stroke patients are often fragile individuals already undergoing complex therapies, such as anticoagulants, antihypertensives, or antidiabetics,” highlights Carlo Andrea Galimberti, President of LICE (Italian League Against Epilepsy). Therefore, the introduction of anti-seizure drugs must consider potential drug interactions and the patient’s overall clinical profile.
A key collaboration between A.L.I.Ce. Italia Odv and LICE
The partnership between A.L.I.Ce. Italia Odv (Italian Stroke Association) and LICE represents a significant step in understanding and managing the link between stroke and epilepsy. Andrea Vianello, President of A.L.I.Ce., emphasized that this collaboration aims to improve patient quality of life through the sharing of best practices and available resources.
Managing post-stroke epilepsy is complex, but advancements in research and new-generation anti-seizure drugs offer treatments that are more tolerable and less prone to interactions with other therapies, as highlighted by neurologist Laura Tassi, LICE past president.
An integrated approach, involving specialists in cerebrovascular and neurological diseases, is crucial to addressing these increasingly common conditions among adults over 60.
What’s your take on this topic? Share your thoughts by leaving a comment in the form below!
