Post-Stroke Seizures 

Seizures are caused by sudden disorganized electrical activity in the brain and be can be characterized by spasms or convulsions. About 10% of stroke survivors experience seizures.

In the first few weeks following a stroke some stroke survivors will experience a seizure. As a general rule, seizures that first occur immediately shortly after a stroke are unlikely to became a permanent, recurrent disorder. On the other hand, seizures that first occur weeks or months after a stroke can be a recurring problem and require medication. Seizures like this are also know as stroke-related epilepsy.

Some physicians will prescribe a temporary anti-seizure medication as a preventative measure immediately after a stroke even if no seizure has occurred. This is most often done in the case of hemorrhagic strokes, which are more prone to seizures rather than ischemic strokes.

Stroke-related epilepsy can typically be fully controlled with anti-seizure medicines. 
More than 20 different anti-seizure medications are available today, all with different benefits and side effects. Taking medications regularly as prescribed is very important in post-stroke seizure management.

The latest studies of post-stroke seizure treatment show that newer drugs, such as lamotrigine, gabapentin, and levetiracetam, in low doses are often prescribed because of their high rate of long-term seizure-free periods, improved safety profile, and fewer interactions with other drugs, especially anticoagulant ones. 

Work with your doctor to find the best medicines for you.

What to do if you see someone having a seizure
The National Institutes of Health has established guidelines for what to do if someone is having a seizure:
  • Roll the person on his or her side to prevent choking on any fluids or vomit.
  • Cushion the person's head.
  • Loosen any tight clothing around the neck.
  • Don't restrict the person from moving or wandering unless he or she is in danger.
  • Do NOT put anything into the person's mouth, not even medicine or liquid. These can cause choking or damage to the person's jaw, tongue, or teeth. Remember, people cannot swallow their tongues during a seizure or any other time.
  • Remove any dangerous objects the person might hit or walk into during the seizure.
  • Note how long the seizure lasts and what symptoms occurred so you can tell a doctor or emergency personnel if necessary.
  • Stay with the person until the seizure ends.
Call 911 if:
  • The person is pregnant or has diabetes.
  • The seizure happened in water.
  • The seizure lasts longer than 5 minutes.
  • The person does not begin breathing normally or does not regain consciousness after the seizure stops.
  • Another seizure starts before the person regains consciousness.
  • The person injures himself or herself during the seizure.
  • This is a first seizure or you think it might be. If in doubt, check to see if the person has a medical identification card or jewelry stating that they have epilepsy or a seizure disorder.
After the seizure ends, the person will probably be groggy and tired. He or she also may have a headache and be confused or embarrassed. Try to help the person find a place to rest. If necessary, offer to call a taxi, a friend, or a relative to help the person get home safely.

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