Seizures in the context of occult cerebrovascular disease

Emsley, Hedley and Parkes, Laura M. (2020) Seizures in the context of occult cerebrovascular disease. Epilepsy and Behavior, 104 (B). ISSN 1525-5050

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There is an important bidirectional relationship between seizures and cerebrovascular disease (CVD). Aside from poststroke epilepsy, Occult CVD is an important cause of late-onset seizures (LOS) and late-onset epilepsy (LOE). Late-onset seizures/LOE are associated with a threefold increased risk of subsequent clinical stroke. This relationship exists not only in later life, but with ‘late-onset’ seizures or epilepsy occurring from the fourth decade of life onwards. There is increasing evidence for the importance of hypertension and cerebral small vessel disease (SVD) in epileptogenesis, but there is a considerable need for further work to elucidate underlying mechanisms. There may be a disproportionately increased risk of intracerebral hemorrhage (ICH) after LOS/LOE; this too requires further study. There is also a bidirectional relationship between LOS/LOE and cognitive impairment/dementia: it is likely that there are important interactions between vascular and neurodegenerative pathological processes mediating LOE, stroke, and dementia. There is a pressing need for better epidemiological and natural history data as well as elucidation of epileptogenic mechanisms, in order to progress our understanding and to better inform clinical practice.

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Journal Article
Journal or Publication Title:
Epilepsy and Behavior
Additional Information:
This is the author’s version of a work that was accepted for publication in Epilepsy & Behavior. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Epilepsy & Behavior, 104, B, 2020 DOI: 10.1016/j.yebeh.2019.06.039
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Deposited On:
15 Jul 2019 14:05
Last Modified:
15 Oct 2023 00:34