After a stroke, are seizures normal?

3 answers | Last updated: Oct 29, 2016
A fellow caregiver asked...

My healthy, 84 year old father suffered from a non-hemorrhaging stroke 2 years ago caused by afib. He recovered pretty well with just a decreased visual and awareness field remaining. He is on Coumadin. All was fine until seizures began - 3 in 3 months. They bring back all the initial stroke symptoms, weakness on left, speech problems and confusion. A 3 day hospital stay and several weeks of rehab are required each time. I thought seizures last just a few hours. The neurologist is baffled, too. Keppra has been increased several times and is now 1500 mg 2x per day.

Blood pressure is in check and Diabetes is regulated with diet and Metformin. What else should we be looking at?

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Seizures after a stroke are not too uncommon, and can present long after the initial stroke occurred. They are due to scarring of the normal pathways in the brain - I often compare this to an electrical fire in a building with damaged wires. And, at his age, it is not unrealistic to think that the seizures would make him sedated for several days.

The best thing to do in a situation like this is to try and control the seizures with medicines that will not sedate him. In someone his age, one medicine that I particularly like is lamotrigine. It tends to be gentle, with few side effects, if started slowly. You can ask your doctor about that medicine specifically. It could be added to, or replace, the Keppra. At high doses I have found that Keppra can be sedating for someone your father's age.

Also, to be sure nothing else is going on, an EEG, MRI, and MR angiogram could be performed. This should help solidify the diagnosis of seizure, and make sure that other strokes are not occurring.

Community Answers

Howard3 answered...

I had a major stroke caused by a clot at age 56 and I am 61 now. I had my first seizure (grand mal seizure) 6 months after my stroke and then every six months (almost to the day) for about a year and a half. ( I remember the every 6 months part because in the state of Washington you cannot drive for 6 months after a seizure) My seizures typically lasted about 3 minutes, and required a visit to the ER and an overnight stay. i am phenytoin (400mg/day) and I have been seizure free for over 2 years now. I have not experienced any side effects.

Simcha44 answered...

I had a seizure as a result of in a car accident in July. I had bleeding on the brain and was in rehab for 3 months. There was additional bleeding on the brain which caused a continuous headache. I thought it had something to do with my sinuses. In October I had a second seizure just prior to a CT scan. I had brain surgery within 24 hours. I have been on Keppra since then and will probably remain on it until October. I see the neurologist again in November. She told me that I could drive, however, I don't currently have a vehicle. So far, so good. I haven't been spending so much time on the internet. My doctor told me that I am fortunate to be alive after reading my medical report! PTL