Suprun S. Symptomatic, local dependent epilepsy in patients after ischemic stroke

In the thesis a complex analysis of neurological disorders and impairments of functional brain conditions in patients after ischemic stroke complicated by symptomatic local dependent epilepsy was carried out. It was revealed that incidence of epilepsy in patients after ischemic stoke was 9,2% of their total amount approximately. It was demonstrated that in the most cases (81%) epileptic seizures appeared the first time in a recovery period of ischemic stroke (late seizures), in 19% of patients epileptic seizures appeared the first time as one of the symptoms of acute ishemic stroke. Among patients with postischemic local dependent epilepsy there was a prevalence of patients with a nidus in a vasculation zone of the middle cerebral artery (71,6% of cases were in the frontal lobe). Epilepsy of the temporal lobe occurred at 17,9%, and epilepsy of the parietal and occipital lobes occurred at 5,3% for each one. It was revealed relations between level of a neurological deficit and a type of epileptic seizures: patients after ischemic stroke with a mild neurological deficit significantly more often developed the secondary generalized seizures and patients with a greater neurological deficit developed the simple generalized ones. Taking into account a little informative value of a common EEG investigation in the work an investigation of functional brain conditions in patients with post-stroke epilepsy by means of assessment of visual evoked potentials (VEP) was carried out. It was shown that in patients after stroke with epileptic disorders versus the control group (patients after ischemic stroke without epileptic disorders) was recorded statistically significant high amplitudes of late VEP components (P100, N145, P200). The increasing of the N145 and P100 components is specific for patients after ischemic stroke with epileptic disorders only. The results of complex clinical and neurophysiological examinations with usage of the method of VEP recording on a reversion of the chess pattern allow to define prognosticcriteria for heaviness of the course of epilepsy. The localization of the nidus in the left hemisphere, frontal lobe of the brain, the presence of a significant neurological deficit and a decreasing of amplitude of a late components of the visual evoked replay allow to prognosticate a bad course of epilepsy.