A case of poststroke early seizure with aphasia: early seizure with non-convulsive symptom

Abstract

We report a case of early seizure with aphasia that occurred after an ischemic stroke. A 54-year old man who suffered from an ischemic stroke experienced aphasia a day after stroke onset. The patient’s aphasia rapidly improved. Therefore, we first diagnosed the patient with a fluctuating ischemic attack. On day 5 of admission, he developed an aphasia again and convulsion. Electroencephalography during the attack revealed rhythmic delta waves in the left hemisphere, mainly in the left frontotemporal area. Because of the rapid improvement in the electroencephalographic abnormalities and symptoms after administering diazepam, we diagnosed his condition as an early poststroke seizure. Because the seizures recurred, lacosamide was initiated. After starting antiepileptic agents, these symptoms did not recur. Distinguishing between early poststroke seizures with focal signs and transient ischemic conditions is difficult. Therefore, early seizures should be considered when treating patients who have suffered from acute stroke and have fluctuating focal signs.