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Medical Management of Seizures in Cerebrovascular Disorders

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Seizures in Cerebrovascular Disorders

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Abstract

Management of seizures and epilepsy in persons who have had a cerebrovascular accident is a complex process involving a number of decisions. Was the event in question an epileptic seizure? If so, should treatment be initiated after a single seizure? If treatment is considered necessary, which antiepileptic drug (AED) should be used to prevent seizure recurrence?

Seizures may present in different settings. Some seizures present in the acute phase of a cerebrovascular accident, often when the patient is in the intensive care unit. Others present weeks or months after a stroke, in which case the recurrence rate is high if untreated, often leading to the diagnosis of epilepsy, rather than single seizures. The pathophysiology, treatment modalities, and consequences of acute poststroke events differ greatly from late seizures and are discussed separately in this chapter. In addition, we discuss the challenges associated with management of seizures and epilepsy in the elderly (Leppik, Walczak, Birnbaum, Lancet, 380:1128–1130, 2012).

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Authors and Affiliations

  1. Department of Neurology, The George Washington Medical Faculty Associates, 2150 Pennsylvania Ave NW, Washington, DC, 20037, USA

    Uma Menon MD

  2. Department of Neurology & Pharmacy, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA

    Prof. Ilo E. Leppik MD

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  1. Uma Menon MD
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Correspondence to Uma Menon MD .

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Editors and Affiliations

  1. Department of Neurology Director, Epilepsy Center, George Washington University, Washington DC, District of Columbia, USA

    Mohamad Z. Koubeissi

  2. SSM-Neurosciences Institute and St. Louis University, St. Louis University, Missouri, Missouri, USA

    Amer Alshekhlee

  3. Vascular Neurology Fellow, University of Virginia, Charlottesville, Virginia, Virginia, USA

    Prachi Mehndiratta

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Menon, U., Leppik, I. (2015). Medical Management of Seizures in Cerebrovascular Disorders. In: Koubeissi, M., Alshekhlee, A., Mehndiratta, P. (eds) Seizures in Cerebrovascular Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2559-9_10

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