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Seizures After Stroke

Seizures After Stroke

Table of Contents

What Is A Stroke?

When blood supply to the brain is cut off, it results in a severe medical condition known as a stroke. This can cause a range of issues, such as problems with speech, paralysis, and cognitive impairment. Different types of strokes exist, and each has its own distinctive features and treatment methods. If left untreated, a stroke can lead to the death of about 1.9 million brain cells per minute, according to the Centers for Disease Control and Prevention. While some brain cells can recover from oxygen deprivation, once they die, they are irreparable. Click here to learn more about Stokes, classification, symptoms, and treatments by clicking here.

What Is A Seizure?

A seizure is a sudden and uncontrolled electrical disturbance in the brain, a neurological disorder, which can cause changes in behaviour, movements, sensations, or consciousness. Seizures can occur for various reasons, including infections, brain injury, genetic factors, or underlying medical conditions. They can manifest in different ways, such as convulsions, jerking movements, staring spells, or altered states of awareness. Seizures can be mild or severe, and their frequency and duration can vary. People are likely to have seizures after a severe stroke. They can also significantly impact a person’s quality of life, affecting their ability to drive, work, or socialise. Treatments for seizures may include medication, lifestyle changes, or surgery, depending on the cause and severity of the condition.

Seizure Symptoms

Some common symptoms of a seizure can include jerking movements (clonic), stiffening movements (tonic), staring off into space (absence seizures), excessive saliva, increased heart rate, hallucinations, eye blinking and eye-rolling, muscle spasms, alternate jerking and stiffening (tonic-clonic), shaking, tremors, lip-smacking and other repetitive movements. Seizures generally last for less than 3 minutes and will normally stop by themselves without treatment however, you must time the seizure and seek medical assistance. Late-onset seizures are more commonly associated with generalised onset seizures (tonic-clonic), including the entire brain and body. In contrast, early-onset seizures typically present with a focal onset.
Seizure symptoms

Causes Of Seizures

Seizures can be caused by various conditions, including epilepsy, brain tumours and infections, head injuries, brain injury, congenital disabilities, flashing lights, high temperatures, illicit drugs, excessive alcohol consumption and withdrawal, lack of sleep, and some prescribed medications. Occasionally seizures can be triggered by no apparent reason.

If you have had a severe (or massive) stroke, a haemorrhagic stroke, or a stroke in the cerebral cortex region of the brain, you are at an increased risk of experiencing seizures.

Differences Between Stroke And Seizures

Seizures and strokes are neurological disorders affecting the brain but have distinct differences.

Seizure Vs Stroke

A seizure is a sudden and uncontrolled electrical disturbance in the brain that can cause changes in behaviour, movements, sensations, or consciousness. Seizures can be caused by various factors, such as brain injuries, infections, genetic factors, or underlying medical conditions. Seizures can last from a few seconds to several minutes and can have different symptoms depending on the type and severity of the seizure.

On the other hand, a stroke is a medical emergency when blood flow to a part of the brain is interrupted by a blockage or a bleed. Strokes can cause damage to brain cells and can lead to a range of symptoms, such as weakness, numbness, difficulty speaking, vision problems, or confusion. Various factors, such as high blood pressure, smoking, diabetes, or heart disease, can cause strokes.

While seizures and strokes share some similarities, they are fundamentally different conditions with distinct causes, symptoms, and treatments. Seizures can occur due to a stroke, but not all seizures are caused by strokes, and not all strokes lead to seizures. If you or someone you know is experiencing symptoms of a seizure or stroke, seek immediate medical attention.

Seizure after a stroke

Can A Stroke Cause Seizures?

Yes, a stroke can cause seizures. When a stroke occurs, there is a disruption in blood flow to a part of the brain, which can lead to abnormal electrical activity and an increased risk of seizures. This type of seizure is called a “stroke-related seizure” or “post-stroke seizure.”

Post-stroke seizures can occur within hours or days of a stroke and may cause different symptoms, depending on the location and severity of the stroke. Post-stroke seizures can also occur months or years after a stroke, especially in people with a history of seizures or brain damage.

The risk of post-stroke seizures can vary depending on the type and location of the stroke, but it is estimated to be around 5-10% in people who have had a stroke. If you or someone you know has had a stroke and is experiencing seizure symptoms, seek medical attention immediately.

Will I Get Epilepsy After A Seizure?

Having a seizure does not necessarily mean that epilepsy will develop. Epilepsy, a neurological disorder characterised by recurrent seizures without apparent cause, is more probable if chronic seizures occur more than once a month. However, if you have fully recovered and not experienced a seizure, your chances of developing epilepsy are very low.

Stroke Seizures And Death

A seizure after a stroke can increase the risk of death, especially if the seizures are frequent or prolonged. Seizures after a stroke can cause additional brain damage and lead to complications such as aspiration, pneumonia, or cardiac arrest. The risk of death is higher in people with a severe stroke, multiple seizures, or other underlying medical conditions.

However, not all people who have a seizure after a stroke will die, and many can recover with appropriate medical care and management of their condition. It’s essential to seek medical attention immediately if you or someone you know experiences symptoms of a seizure after a stroke to prevent complications and improve the chances of recovery.

Life Expectancy After Stroke And Seizure

The life expectancy after a stroke and seizure can vary widely, depending on several factors such as the type, severity, and location of the stroke, the frequency and duration of seizures, and other underlying medical conditions.

Generally, having a stroke or a seizure can increase the risk of disability, cognitive impairment, and mortality, especially in older adults. However, with appropriate medical care and management of risk factors, many people can recover from a stroke or seizure and lead a fulfilling life.

Lifestyle changes such as maintaining a healthy diet, exercising regularly, quitting smoking, and controlling blood pressure and cholesterol levels can help reduce the risk of further strokes or seizures and improve overall health. It’s essential to seek regular medical check-ups and follow-up care to manage ongoing conditions and prevent complications.

Treatment For Post-stroke Seizure 

Treatment depends on the frequency and severity of the seizures and the underlying cause of the stroke. In most cases, medication is the first line of treatment for post-stroke seizures.

Antiepileptic drugs (AEDs) are commonly used to prevent or reduce the frequency of seizures. The choice of AED depends on several factors, such as the type of seizures, the age and overall health of the patient, and other medical conditions.

In some cases, other treatments, such as surgery to remove brain tissue causing seizures or electrical stimulation, may be necessary. Lifestyle changes, such as reducing stress, getting enough sleep, and avoiding alcohol and drugs, can also help reduce the risk of seizures.

It’s essential to work closely with a healthcare provider to develop a comprehensive treatment plan that addresses the underlying cause of the stroke and the seizures and helps manage any other medical conditions. Regular monitoring and adjustment of the treatment plan may be necessary to ensure optimal outcomes and prevent complications.

Recurrent Seizures

Recurring seizures mean having more than one seizure. The reason for your seizures may not be known, or there may be an underlying cause. Epilepsy is a disorder in which recurrent seizures occur without specific reason or cause. Post stroke epilepsy is recurrent seizures after a stroke. Stroke patients will more than likely be diagnosed with post stroke epilepsy if they have two or more unprovoked seizures after a stroke. Some other common reasons for recurring seizures are lack of sleep, alcohol, drugs and viruses.

Severe Stroke

Severe Stroke

A severe stroke is a medical emergency that can have devastating consequences for the patient. A stroke occurs when the blood flow to a part of the brain is interrupted or reduced, depriving the brain cells of oxygen and nutrients. This can lead to brain damage and a wide range of physical and cognitive impairments, including paralysis, speech problems, and memory loss.

These types of strokes are characterised by the extent and severity of the brain damage. The severity of a stroke is typically measured using the National Institutes of Health Stroke Scale (NIHSS), which assesses the patient’s ability to speak, move, and think. A severe stroke is usually defined as a score of 16 or higher on the NIHSS.

The symptoms can vary depending on the affected area of the brain. Some of the most common symptoms include

  • Sudden weakness or numbness in the face, arm, or leg, especially on one side of the body.
  • Difficulty speaking or understanding speech.
  • Vision problems, such as blurred or double vision.
  • Severe headache.
  • Loss of balance or coordination.
  • Confusion or disorientation.

The first few hours after a stroke are critical, and prompt treatment can help reduce the risk of long-term disability or death. The standard treatment for a severe stroke is thrombolytic therapy, which involves the administration of a clot-busting medication to dissolve the blood clot blocking the blood flow to the brain. However, thrombolytic therapy is only effective if administered within 4.5 hours of the onset of symptoms.

If thrombolytic therapy is not an option, the patient may undergo endovascular therapy, which involves the insertion of a catheter into the blocked blood vessel to remove the clot. Surgery may sometimes be necessary to remove the clot or repair the damaged blood vessels.

After the acute phase of a stroke, the patient will typically undergo rehabilitation to regain lost function and improve their quality of life. Depending on the patient’s specific needs, this may involve physical therapy, speech therapy, occupational therapy, and other forms of therapy.

A severe stroke is a medical emergency that requires immediate attention. It can have serious and long-lasting consequences for the patient, but prompt treatment and rehabilitation can help reduce the risk of disability and improve the patient’s quality of life. If you or someone you know is experiencing stroke symptoms, seek medical attention immediately.

Ischemic Stroke

The most common type of stroke is an ischemic stroke, caused by a clot obstructing blood flow to a specific brain region. The clot may form in the brain, known as cerebral venous thrombosis, or it may develop elsewhere in the body and travel to the brain, known as cerebral embolism, resulting in a stroke. People with ischemic stroke in their cerebral cortex and hippocampus are more likely to develop seizures.

On the other hand, a haemorrhagic stroke occurs when blood vessels in the brain rupture, leading to a build-up of blood in the surrounding brain tissue. This can pressure the brain, depriving parts of it of oxygen and blood supply. According to estimates from the American Stroke Association, around 13 per cent of all strokes are haemorrhagic.

Controlling Post Stroke Seizures

Seizures are a common complication of stroke, affecting up to 10% of stroke survivors. Seizures after stroke (post stroke seizure) can be a significant challenge for patients and caregivers, as they can cause physical injury and impair recovery. Therefore, controlling post-stroke seizures is an essential part of stroke management.

The following strategies can be used to control post-stroke seizures:


Medications are the primary treatment for post-stroke seizures. They work by stabilising the electrical activity in the brain and preventing seizures. Several antiepileptic medications are available, and the choice of medication depends on the patient’s seizure type, medical history, and medication tolerance.

Lifestyle Modifications:

Certain lifestyle modifications can help control post-stroke seizures. Patients should avoid alcohol and drugs, as they can trigger seizures. Getting adequate sleep and reducing stress levels can also be helpful.

Surgical Options:

Despite optimal medical management, surgical options may be considered for patients with recurrent seizures. These may include resection of the seizure focus or implantation of a vagus nerve stimulator.


Stroke rehabilitation is essential to prevent seizures. Rehabilitation aims to help the patient regain lost function and improve the overall quality of life. This can include physical therapy, occupational therapy, and speech therapy.

Patient Education:

Educating patients and their caregivers about post-stroke seizures can help prevent and manage them. This can include teaching patients about triggers that can cause seizures and what to do if a seizure occurs.

Controlling a post-stroke seizure is crucial to ensure the best possible outcomes for stroke survivors. A multidisciplinary approach involving medications, lifestyle modifications, rehabilitation, and patient education can effectively manage post-stroke seizures. It is important to work closely with a healthcare professional to determine the best treatment plan for each individual patient.

Patient education

Focal Onset Seizures

Also known as partial seizures, originate from a specific area or group of cells in one hemisphere of the brain. These seizures may manifest as abnormal movements, sensations, or emotions, depending on the location of the affected brain cells.

These types of seizures can be further classified as either simple or complex, depending on whether or not the individual maintains awareness during the seizure. In simple focal onset seizures, the individual remains conscious and aware of their surroundings but experiences abnormal sensations or movements, such as tingling, twitching, or jerking in one part of the body. In contrast, complex focal onset seizures may involve altered awareness or loss of consciousness and complex behaviours such as repetitive or automatic movements.

The symptoms of focal seizures vary depending on the specific region of the brain that is affected. They may involve movements, sensations, emotions, or alterations in consciousness, lasting from a few seconds to several minutes. If you are experiencing focal onset seizures, seeking medical attention and receiving a proper diagnosis and treatment plan is important.

The Takeaway

Seizures can occur after a stroke, and it’s essential to be aware of the signs and symptoms, such as confusion, loss of consciousness, and muscle spasms. Early detection and treatment of seizures can reduce the risk of further brain damage and improve stroke survivors’ quality of life. Working closely with a healthcare provider to manage seizures and prevent future strokes is crucial.

With proper first aid training, one can stay informed and proactive, where individuals can take control of their health and make positive changes to enhance their overall well-being. Remember, stroke recovery is a journey, and with the right support, achieving a better and healthier life is possible.

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