RESUMENEn las personas mayores de 60 años, el ictus es la causa más frecuente de epilepsia. La tasa global de epilepsia post ictus varía del 2% al 4%. La localización cortical y el tamaño de la isquemia son los factores que están asociados con crisis epilépticas post ictus. Las crisis epilépticas de inicio tardío se asocian frecuentemente con el desarrollo de epilepsia post ictus, siendo su principal manifestación clínica las convulsiones parciales con generalización secundaria. Además de los estudios de imagen, el electroencefalograma es de considerable ayuda durante el inicio de crisis, así como durante el seguimiento, donde el patrón más frecuente son ondas lentas focales. El tratamiento con drogas antiepilépticas debe iniciarse con bajas dosis, y lentamente incrementarlas hasta alcanzar la dosis efectiva. Los nuevos fármacos son los preferidos, debido a su baja tasa de efectos colaterales.PALABRAS CLAVE: Epilepsia, ictus, accidente cerebrovascular, ataque cerebrovascular, convulsiones SUMMARYIn people over 60 years, stroke is the most frequent cause of epilepsy. The overall rate of post-stroke epilepsy varies from 2% to 4%. The location and size of cortical ischemia are among the factors associated with poststroke seizures. Late -onset seizures are more frequent associated with the development of post stroke epilepsy, being its main clinical manifestations partial seizures with secondary generalization. In addition to imaging studies,electroencephalography is of considerable assistance during the initial period and during follow-up, where the most common pattern is focal slowing. Antiepileptic drug treatment should be started at low doses and slowly be increased until effective doses are reached. Newer antiepileptic drugs are preferred due to their low rate of side effects.
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