CLINICAL, IMMUNOLOGICAL, NEUROPHYSIOLOGICAL, AND GENETIC PREDICTORS OF SYMPTOMATIC EPILEPSY FOLLOWING STROKE

Abstract

Background: Post-stroke epilepsy is a common complication of cerebrovascular events, significantly affecting patients’ neurological outcomes and quality of life. Its development is influenced by multiple factors, including stroke type, lesion location, neuroinflammatory processes, and genetic predisposition. Objective: To evaluate the prognostic significance of clinical-neurological, immunological, neurophysiological, and genetic factors in the development of symptomatic epilepsy following ischemic or hemorrhagic stroke. Methods: A prospective observational study was conducted on 82 patients aged 45–85 years who had experienced ischemic or hemorrhagic stroke. Clinical evaluation included neurological deficit assessment using the NIHSS, imaging studies, and risk factor analysis. Neurophysiological assessment was performed using EEG, immunological markers were measured through cytokine levels (IL-1β, IL-6, TNF-α), and genetic polymorphisms associated with neuroinflammation and neuronal excitability were analyzed. Patients were followed for 12 months for seizure occurrence and neurological changes. Results: Symptomatic post-stroke epilepsy developed in 18 patients (21.9%). Significant predictors included cortical lesion location, hemorrhagic stroke type, high NIHSS scores, early epileptiform activity on EEG, elevated IL-6 and TNF-α levels, and specific genetic polymorphisms. A combined analysis of clinical, neurophysiological, immunological, and genetic factors allowed accurate risk stratification. Conclusions: Post-stroke epilepsy is a multifactorial condition influenced by clinical, neurophysiological, immunological, and genetic factors. Comprehensive assessment of these parameters improves prognostic accuracy and may guide personalized preventive and therapeutic strategies.