Brain Areas Predisposing to the Stroke-Related Epilepsy Development

Background. Stroke-related epilepsy (STRE) represents a significant health problem. We focused on identifying brain areas, which involvement in ischemia predisposes a patient to STRE development. Methods. We retrospectively identified a group of patients with STRE consisting of 33 subjects. Subsequently, age-, sex-, and territory-matched controls who underwent stroke but did not develop STRE (control group (CG)) were identified. The CG was composed of 37 patients. The total ischemia volume and distribution of ischemic changes were compared between STRE and CG. We also analyzed multivariate statistics to identify independent variables predisposing to STRE development. Results. The patients with STRE exhibited a bigger volume of ischemia than CG (average volume of ischemia in STRE 60.8 cm3, in CG 42.4 cm3, p=0.029). When comparing STRE and CG, there were differences in the distribution of ischemic changes in the temporal lobe (transverse (Heschl's) temporal gyri, superior temporal gyrus, and middle temporal gyrus) and parietooccipital region (postcentral gyrus, supramarginal gyrus, angular gyrus, parietal operculum, lingual gyrus, and superior occipital gyrus). The involvement of transverse temporal (Heschl's) gyri (p=0.0222, odds ratio 30.0767), age (p=0.0110, odds ratio 1.0745), and SeLECT score (p=0.0480, odds ratio 1.8682) were identified as independent predictors for STRE development. Conclusion. The higher volume of ischemia correlates with a higher risk of STRE development. Some areas, particularly in the temporal and parietal neocortex, predispose the brain to generate epilepsy after the stroke.