Epilepsi Paska Stroke: Laporan Kasus

a case report about post stroke epilepsy in regional hospital Dr. R. Soedjono Selong

Authors

  • Sani Solihatul Fitri Rsud Dr. R. Soedjono Selong
  • Safat Wahyudi Neuology Departement, General Hospital Dr. R. Soedjono Selong, Selong, Indonesia

DOI:

https://doi.org/10.29303/jku.v12i3.966

Keywords:

seizures, epilepsy, stroke

Abstract

Abstract: Post-stroke seizures is a common complication in post-stroke patients, it is reported that about 8-15 % of cases may develop into post-stroke epilepsy. A 54-year-old man was referred from Primary Health Care with a complaint of seizures on the right side of the body for more than 30 minutes. Seizures have often occurred since last year after the patient had a stroke attack. The patient has had 2 strokes attack in 2021 and 2022. The seizure stopped right before the patient arrived in the emergency room. The patient experienced weakness on the right side of the body and was unable to speak since his 1st stroke attack. When the patient was transferred to the neurology ward, he experienced another seizures, the duration of seizure < 2 minutes, with the frequency >3 times, the patient remained conscious during the event. We give phenytoin 100 mg/8 hours. Head CT in 2022 shows an infarction in the middle cerebral artery. Brain ischemia causes damage to neurons which causes an imbalance between inhibitory neurons and excitatory neurons which causes seizures. Seizures in post-stroke patients are divided into early-onset and late-onset seizures. Male stroke patients aged <65 years with history of hypertension, history of stroke involving the territorial MCA have a higher risk of developing Post Stroke Epilepsy (PSE). The patient in this case has a high risk of experiencing PSE because his past stroke involving the territorial MCA, besides that there is history of uncontrolled hypertension and age < 65 years.

References

References

Alsaad, F., Alkeneetir, N., Almatroudi, M., Alatawi, A., Alotaibi, A., Aldibasi, O., Khatri, IA. (2022). Early seizures in stroke - frequency, risk factors, and effect on patient outcomes in a tertiary center in Saudi Arabia. Neurosci Riyadh Saudi Arab. 2022 Apr;27(2):104– 10. https://doi.org/10.17712/nsj.2022.2.20210144

Brondani, R., Almeida, A.G., Cherubini, P.A., Secchi, T.L., Oliveira M.A., Martins, S.C., Bianchin, M.M. (2020). Risk Factors for Epilepsy After Thrombolysis for Ischemic Stroke: A Cohort Study. Front. Neurol., 23 January 2020. https://www.frontiersin.org/articles/10.3389/fneur.2019.01256

Chen, Z., Churilov, L., Chen, Z., Naylor, J., Koome, M., Yan, B. Kwan, P.(2018). Association between implementation of a code stroke system and poststroke epilepsy. Neurology. 2018 Mar 27;90(13):e1126–33. https://doi.org/10.1212/WNL.0000000000005212

Fisher, R.S., Cross, J.H., Souza, C.D., French, J.A., Haut, S.R., Higurashi, N., Hirsch, E., Jansen, F.E., Lagae, L., Moshe, S.L., Peltola, J., Perez, E.R., Scheffer, I.E., Bonhage, A.S., Somerville, E., Sperling, M., Yacubian, E.M., & Zuberi, S.M. (2017). Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia, 58(4):531–542, 2017 https://doi.org/10.1111/epi.13671

Galovic, M., Atuesta, C.F., Abraira, L., Dohler, N., Sinka, L., Brigo, F., Bentes, C., Zelano, J., & Koepp, M.J. (2021). Seizures and Epilepsy After Stroke: Epidemiology, Biomarkers and Management. Drugs & Aging (2021) 38:285–299. https://doi.org/10.1007/s40266-021-00837-7.

Hardstock, F., Foskett, N., Gille, P., Joeres, L., Molzan, M., Wilson J.C., Wilke, T., Holtkamp, M. (2021). Poststroke epilepsy incidence, risk factors and treatment: German claims analysis. Acta Neurologica Scandinavia 2021;143:614–623. https://doi.org/10.1111/ane.13403

Huang, H.L., Zhou, H., Wang, N., Yu, C.Y. (2016). Effects Of Antiepileptic Drugs On The Serum Folate And Vitamin B12 In Various Epileptic Patients. Biomedical Reports 5: 413-416, 2016. https://doi.org/10.3892/br.2016.737

Lidetu, T., & Zewdu, D. (2023). Incidence and predictors of post stroke seizure among adult stroke patients admitted at Felege Hiwot compressive specialized hospital, Bahir Dar, North West Ethiopia, 2021: a retrospective follow up study. BMC Neurology (2023) 23:40. https://doi.org/10.1186/s12883-023-03083-z

Lin, R., Yu, Y., Wang, Y., Foster, E., Kwan, P., Lin, M., Xia, N., Xu, H., Xie, C., Yang, Y., & Wang, X. (2021). Risk of Post-stroke Epilepsy Following StrokeAssociated Acute Symptomatic Seizures. Front Aging Neurosci. 2021 Sep 13;13:707732. https://doi.org/10.3389/fnagi.2021.707732

Phan, J., Ramos, M., Soares, T., Parmar, M.S. (2022). Poststroke Seizure and Epilepsy: A Review of Incidence, Risk Factors, Diagnosis, Pathophysiology, and Pharmacological Therapies. Oxidative Medicine and Cellular Longevity Volume 2022, Article ID 7692215, 15 pages. https://doi.org/10.1155/2022/7692215

Shen, L., Yang, J., & Tang, Y. (2021). Predictive Values of the SeLECT Score and IL-1β for Post-Stroke Epilepsy. Neuropsychiatric Disease and Treatment 2021:17 2465–2472. https://doi.org/10.2147/NDT.S324271.

Waafi, A.K., Husna, M., Damayanti, R., Setijowati, N. (2023) Clinical Risk Factors Related To Post-Stroke Epilepsy Patients In Indonesia: A Hospital-Based Study. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery (2023) 59:39. https://doi.org/10.1186/s41983-023-00637-3.

Xu, Y., Zhang, N., Xu, S., Xu, H., Chen, S., Xia, Z. (2019). Effects of phenytoin on serum levels of homocysteine, vitamin B12, folate in patients with epilepsy A systematic review and meta-analysis (PRISMA-compliant article). Medicine 98(12):p e14844, March 2019. http://dx.doi.org/10.1097/MD.0000000000014844

Zhou, H., Wang, N., Xu, L., Huang, H.L., Yu, C.Y. (2017) Clinical study on anti-epileptic drug with B vitamins for the treatment of epilepsy after stroke. European Review for Medical and Pharmacological Sciences 2017; 21: 3327-3331. https://www.europeanreview.org/wp/wp-content/uploads/3327-3331-Anti-epileptic-drugs-and-B-vitamins-for-epilepsy-after-stroke.pdf.

Downloads

Published

2023-10-25

How to Cite

Solihatul Fitri, S., & Safat Wahyudi. (2023). Epilepsi Paska Stroke: Laporan Kasus: a case report about post stroke epilepsy in regional hospital Dr. R. Soedjono Selong. Jurnal Kedokteran, 12(3), 257–261. https://doi.org/10.29303/jku.v12i3.966

Most read articles by the same author(s)