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    Early and Late Onset Seizures After Cerebrovascular Disease
    (Kare Publ, 2015) Ozkan, Adile; Gokceer, Sevda Yildiz; Isik, Nihal; Canturk, Ilknur Aydin; Candan, Fatma
    Objectives: This study aimed to compare seizure types, clinical and demographic features, treatment response and prognosis among patients with early and late onset post-stroke seizures. Methods: A retrospective evaluation was made of the data of 46 patients admitted to our clinic between January 2000 and April 2006 diagnosed with cerebrovascular disease, and who had post-stroke epileptic seizures. Two types of post-stroke seizures were defined; 'early onset' (occurring within 14 days post-stroke) and ` late onset' (occurring after the 14th day). Results: Among the 46 patients, 15 (32.6%) had early onset and 31 (67.3%) had late onset seizures. The early onset post-stroke seizures occurred more frequently after hemorrhagic stroke, while the late onset were more often seen in ischemic stroke. Ischemic strokes occurred mostly in the middle cerebral artery area, whereas lobar cortical hematomas were observed in the hemorrhagic stroke patients. The early onset seizures had statistically significant left hemisphere lesions, while those which were late onset had right hemisphere lesions (p<0.038). Secondary generalized seizures were the most common type in both groups. The seizures were well controlled with monotherapy in both groups, but seizure recurrence was found to be higher in the late onset seizure group. Conclusion: This study found significant left hemisphere lesions in the patients with early onset seizures, while in those with late onset seizures, lesions were present in the right hemisphere. In both groups, cortical involvement played an important role. Secondary generalized seizures were the most frequently occurring, and these were treated with antiepileptic monotherapy.
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    Experiences in an Epilepsy Polyclinic: Epilepsy in the Elderly
    (Kare Publ, 2015) Ozkan, Adile; Candan, Fatma; Canturk, Ilknur Aydin; Gokceer, Sevda Yildiz; Isik, Nihal; Karaman, Handan Isin Ozisik
    Objectives: Epilepsy is one of the most common serious neurological disorders in the elderly. In this study the demographic and clinical features, etiological factors, seizure types and response ratios to treatment are presented for a group of patients aged 60 years and over diagnosed with epilepsy. Results: Twenty-five patients aged 60 years and over who applied to the epilepsy polyclinic were retrospectively investigated. Results: Average patient age was 75.0 +/- 7.1 years and average disease duration was 2.32 +/- 1.8 years. Sixteen patients were male and 9 female. Among the patients, cerebrovascular disease (17 patients), brain tumor (1 patient), arachnoid cyst (1 patient), aneurysm (1 patient) and myocardial infarction (1 patient) were considered as the underlying factors in seizure development. In the remaining 4 cases, no etiological cause was determined. Seizure types were; secondary generalized tonic-clonic seizure (20 patients), simple partial seizure (2 patients), status epilepticus seizure (2 patients), and complex partial seizure (1 patient). EEG findings were abnormal in 32% of the patients (n=8). When evaluated for treatment, 18 patients received monotherapy; 6 patients used double, and 1 patient used triple drugs. The follow-up period in 21 cases was without seizure. Conclusion: In the study, the most common etiological cause of epilepsy seen in the elderly was cerebrovascular disease. Seizure type was mainly secondary generalized tonic-clonic. The patients responded well to monotherapy and prognosis was improved.