Clinical and paraclinical characteristics in patients with post-stroke epilepsy

Objective: This study aims to describe the clinical and subclinical characteristics and evaluate the treatment effectiveness of post-stroke epilepsy (PSE) in 85 patients diagnosed at the Neurology Center, Bach Mai Hospital, from January 2023 to June 2024. Results: The study findings showed that the incidence of epilepsy after cerebral infarction (61.11%) was higher than after cerebral hemorrhage (37.78%). The first seizure typically occurred within 6–12 months after the stroke (55.6%), with focal seizures being the most common type (78.9%), particularly focal-to-bilateral tonic-clonic seizures (54.4%). Regarding subclinical features, electroencephalography (EEG) recorded normal background activity in 66.7% of cases, while 33.3% exhibited epileptiform discharges, predominantly focal slow waves (27.8%). Brain MRI results revealed that combined multi-lobe lesions were the most frequent (53.3%), especially in the temporal lobe (17.8%), with 50% of patients having large-sized lesions. Conclusion: Post-stroke epilepsy (PSE) usually occurs within 6–12 months after a stroke, with focal seizures being the most common. EEG often does not detect abnormalities in most patients, whereas MRI frequently shows multi-lobe lesions, particularly in the temporal lobe.