title: Epilepsy in cerebrovascular diseases: Review of experimental and clinical data with meta-analysis of risk factors.
abstract: Seizures may occur in close temporal association with a stroke or after a variable interval. Moreover, epilepsy is often encountered in patients with leukoaraiosis. Although early post-stroke seizures have been studied extensively, less attention has been paid to post-stroke epilepsy (PSE) and to epilepsy associated with leukoaraiosis (EAL). The aim of this paper is to review data concerning pathophysiology, prognosis, and treatment of PSE and EAL.
  
  
  
  We performed an extensive literature search to identify experimental and clinical articles on PSE and EAL. We also conducted a systematic review of risk factors for PSE and EAL among eligible studies.
  
  
  
  PSE is caused by enhanced neuronal excitability within and near the scar. The role played by white matter changes in EAL remains to be elucidated. Meta-analysis showed that cortical involvement (odds ratio [OR] 3.71, 95% confidence interval [CI] 2.34-5.90, p < 0.001), cerebral hemorrhage (OR 2.41, 95% CI 1.57-3.70, p < 0.001), and early seizures (OR 4.43, 95% CI 2.36-8.32, p < 0.001) are associated with an increased risk of PSE. As regards EAL, no prospective, population-based studies evaluated the role of different variables on seizure risk. Studies about the management of PSE are limited. PSE is generally well controlled by drugs. Data about risk factors, prognosis, and treatment of EAL are lacking.
  
  
  
  Pathophysiology and risk factors are well defined for PSE but need to be elucidated for EAL. Management of PSE and EAL relies on the clinician's judgment and should be tailored on an individual basis.
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.|Regional Epilepsy Centre, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.|Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Ferlazzo
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.|Regional Epilepsy Centre, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gasparini
authors.affiliation: Laboratory of Neurological Disorders, IRCCS - Mario Negri Institute for Pharmacological Research Via La Masa, Milan, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
authors.affiliation: Regional Epilepsy Centre, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Sueri
authors.affiliation: Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Viale Europa, Catanzaro, Italy.
authors.forename: Emilio
authors.identifier: 0000-0002-1279-8123
authors.initials: E
authors.lastname: Russo
authors.affiliation: Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Viale Europa, Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Leo
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.|Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Labate
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.|Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gambardella
authors.affiliation: Neurology Unit, Department of Neurosciences, S. Anna Hospital, Ravona, Como, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Belcastro
authors.affiliation: Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, G. Gaslini Institute, University of Genova, Genova, Italy.
authors.forename: Pasquale
authors.identifier: 0000-0002-6065-1476
authors.initials: P
authors.lastname: Striano
authors.affiliation: Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paciaroni
authors.affiliation: IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy.
authors.forename: Laura Rosa
authors.initials: LR
authors.lastname: Pisani
authors.affiliation: Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.|Regional Epilepsy Centre, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.|Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Aguglia
mesh_terms: D000818:Animals; D002561:Cerebrovascular Disorders / Q000150:complications*; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D011379:Prognosis; D012307:Risk Factors
keywords: Animal models; Antiepileptic drugs; Leukoaraiosis; Seizures; Stroke