We retrospectively analyzed the clinical features, prognosis, CT scans and electroencephalograms in 527 patients with
cerebral infarction in the Toranomon hospital between 1983 and 1990. CT scans revealed cortical involvement in 130 cases and subcortical
infarcts in the territory of the perforating branch arteries in 397 cases. The mean duration of the follow up was 38.5 +/- 27 months (M +/- SD). Of these, late onset
seizures developed in 5.69% (30/527). The incidence of
seizures after cortical branch
infarcts was 20% (26/130), which was significantly higher than that after subcortical
infarcts (1%; 4/397) (p < 0.05). These late
seizures could be either generalized or
partial seizures. The interval between
stroke and the onset of
seizures was 2.4 years (mean), and 78% of late onset
seizures developed within 3 years after the
stroke. CT scans of the patients with late
seizures showed that infarcted area was located mainly in the territory of the left middle cerebral artery. The incidence of late
seizures was significantly higher in patients with left cortical
infarction (12/41, 29.3%) than those with right one (6/29, 15.4%, p < 0.05). These results suggest that left-sided cortical involvement may have some liability to late onset
seizures in patients with
cerebral infarction. Further study on indication of prophylactic use of
anticonvulsants might be requested in patients with right
hemiparesis and
aphasia.