Abstracts

Rationale: Cerebral infarction is one of the most common causes of epilepsy, however, it is unclear whether non-cortical infarction can lead to epilepsy. The aim of this study was to evaluate the relationship between epilepsy and non-cortical infarction, namely, lacunar infarction and branch atheromatous disease (BAD), in Japanese patients. Methods: We reviewed medical records and brain MRI of all patients with ischemic stroke who were admitted in the Department of Neurology, Neurosurgery, and Stroke Unit at Kurashiki Central Hospital between January and December, 2012, enrolled patients with lacunar infarction and BAD, and excluded patients with cortical ischemic lesion. Patients who developed epileptic seizures after cerebral infarction were selected and their clinical features were obtained. Results: 42 patients with lacunar infarction (age range from 43 to 97) and 60 patients with BAD (age range from 39 to 98) were enrolled. Among those 102 patients, three BAD patients subsequently developed epileptic seizures (2.9 % of total, 5.0 % of BAD patients). Their seizure onset ages were 54, 77, and 98 years, respectively, 1 to 3 years after they had stroke. Their seizure types were recognized as simple partial seizures and secondarily generalized seizures based on clinical semiology. The 54-year old patient and 98-year old patient had multiple microbleeds in the cerebrum. The 98-year old patient had dementia. Conclusions: In this study, 2.9 % of non-cortical cerebral infarction, and 5.0 % of BAD patients, developed epilepsy. The ratio is higher than the prevalence of epilepsy, i.e., about 0.9 % of all population (World Health Organization, 2005). Our data may suggest the relationship between epileptic seizures and non-cortical infarction. Closer observation would be needed in patients with BAD, microbleeds, and cognitive dysfunction for early recognition and treatment of epileptic seizures.