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Dr. Andrew Rynne

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My patient suffered from epilepsy after stroke and her blood pressure rose during the epileptic attack. What treatment should be given ?

my patient got stroke 3 yrs back after stroke she developed epilepsy what can we do for that she take losartan pottassium 50mg ramipril 5mg for hypertension and also take anti platelet her blood pressure is normal now but during epilepsy her blood pressure rise upto 220 after stroke she developed left hemiparesis . her age is 51year. and epilepsy appear 1year after stroke. please give me a perfect solution......
Mon, 9 Jan 2012
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General & Family Physician 's  Response
Hi Udit, Welcome to HealthcareMagic Forum.
You haven't mentioned whether it was a Ischemic or Hemorrhagic Stroke? Because the chances of Epilepsy are more than 34% after Hemorrhagic stroke and more than 10% after ischemic stroke. Kindly do not worry as stroke related epilepsy can be successfully controlled with antiseizure medicines. The oldest and most commonly used medicines for this purpose are phenytoin and carbamazepine. The newer ones which have been added to this treatment include levetiracetam and lamotrigine .
See to it that she comes to you for regular follow up and she does not miss any dose even if seizure episodes are under good control. She needs to take her stroke medications regularly. She needs to get a adequate sleep for a minimum of 8 Hours daily if she has any abusing habits, she needs to stop it completely. Let her visit Physiotherapy sessions regularly and go for brisk walks. Counsel her attenders as well regarding her condition, that she needs to be taken good care of. Limiting salt intake with brisk walks will keep her blood pressure under control. If these measures are not helping, let her get examined by a Neurologist for further evaluation and get a CT scan of head done to rule out any Pathology. She should be eating soft bland diet with fresh fruits and green leafy veggies.

Good Luck.
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