Details

Autor(en) / Beteiligte

• Emsley, Hedley C.A.
• Parkes, Laura M.

Titel

Seizures in the context of occult cerebrovascular disease

Ist Teil von

• Epilepsy & behavior, 2020-03, Vol.104 (Pt B), p.106396-106396, Article 106396

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. •Occult cerebrovascular disease is an important cause of late-onset seizures and late-onset epilepsy•LOS/LOE are associated with a three-fold increased risk of stroke•‘Late-onset’ should probably be regarded as being from the fourth decade of life onwards•There may be a disproportionately increased risk of ICH after LOS/LOE•There is a bidirectional relationship between LOE/LOS and cognitive impairment/dementia•There is a pressing need for further research in this field, including epidemiological, natural history and mechanistic studies