Seizures After a Stroke

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A stroke is characterized by brain damage due to a lack of blood supply. Damage to brain tissue generally causes under-activity and loss of some type of physical or cognitive function. That is the most recognizable effect of a stroke.

However, damage to brain tissue may also cause over-activity or irregular activity of the brain, resulting in seizures. Some stroke survivors experience seizures after a stroke.

Seizures are usually frightening and confusing events that manifest with uncontrollable and unexpected movements, often accompanied by changes in alertness. A stroke survivor may develop seizures shortly after a stroke or months later. The medications used to control seizures are different from the medications used to prevent strokes.

What is a seizure?

The brain works by electrical activity. A seizure is a spell of abnormal electrical activity in the part of the brain damaged by a stroke. This results in loss of consciousness or movements of the part of the body that corresponds to the damaged portion of the brain. A stroke is more likely to cause seizures if the stroke affects the motor cortex, which is the part of the brain responsible for movement.

One of the confusing things about seizures that occur after a stroke is that it can be difficult to know if you are having a seizure or if you are having another stroke.

So you should get medical attention right away if you experience unusual movements, weakness or loss of consciousness.

Will I have a seizure after my stroke?

Your doctor may mention the possibility of seizures, and if you have any questions about whether you are at risk for developing seizures, you should ask.

Depending on the situation, in selected circumstances, medication for seizure prevention may be started after a stroke. The better the seizure prevention, the less likely seizures are to become a recurrent problem or to cause damage to the brain. Some strokes in certain locations of the brain are highly unlikely to cause a seizure and your neurologist will be able to tell you if you have a high or low likelihood of seizures based on the location of your stroke.

How to cope with seizures after a stroke. 

  • If you have a seizure after a stroke, this does not necessarily mean that you might need seizure medication forever. Some people have post-stroke seizures for a few years and then recover.
  • On the other hand, a seizure after a stroke cannot be ignored. Preventative medication is the safest way to go and will likely decease the frequency and severity of recurrent seizures and protect your brain from further damage.
  • Adjustment of anti-seizure medications may take some time. There may be side effects and sometimes the dosage needs to be modified to prevent seizures.
  • It is unsafe to drive if you have seizures that are not yet well controlled. If you have a seizure while driving, this is unsafe for you, for your passengers and for innocent drivers or pedestrians.
  • If a seizure occurs, that does not mean that you will not recover from your stroke or that more strokes will occur.
  • Some people can learn to recognize a feeling that comes on prior to a seizure. This is often called an ‘aura.’ It is important to rest and get to a safe place if you have an aura. Some doctors might recommend special fast-acting anti-seizure medication to prevent the progression to a seizure once an aura starts. Whether or not you should take this fast acting type of medication depends on your type of seizure, your type of stroke and your other medications.
  • After a seizure, most people feel disoriented and exhausted. Rest is very important.
  • Some habits may increase the likelihood of a seizure. Alcohol, lack of sleep, stress, lack of food, a fever or an illness are common triggers for a seizure.
  • Medication routines are very important. Skipping anti-seizure medication can trigger a seizure.
  • You should never abruptly discontinue anti-seizure medication or discontinue without your doctor’s instructions. Abruptly stopping anti-seizure medication can trigger a seizure. If you experience side affects, call your doctor to plan out a change in your medication. There are safe ways to change medications or medication doses

For some stroke survivors, seizures may develop after a stroke. Seizures can be dangerous, especially when driving, climbing ladders or handling machinery. Seizures are treatable and manageable. The more you know, the better your chances at good seizure control.


Walter G. Bradley DM FRCP, Robert B. Daroff MD, Gerald M Fenichel MD, Joseph Jankovic MD, Neurology in Clinical Practice, 4th Edition, Butterworth-Heinemann, 2003

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