Epilepsi Paska Stroke: Laporan Kasus

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.