After a stroke, many survivors face ongoing health challenges, including the possibility of seizures. While not every stroke survivor will experience seizures, it’s important to understand why they occur, the different types, and how they can be managed.

Seizures after a stroke can be frightening and unpredictable, but with the right treatment and lifestyle adjustments, they can be controlled. Whether you are a stroke survivor or a caregiver, this guide will provide key information on post-stroke seizures, how to recognize them, and the best treatment strategies.

Why Do Seizures Happen After a Stroke?

A stroke damages the brain by cutting off oxygen and blood supply, leading to scar tissue and changes in brain activity. These changes can disrupt normal electrical signals, sometimes triggering a seizure.

Key Reasons Why Post-Stroke Seizures Occur:

✔ Brain Damage & Scar Tissue: The injured brain may develop hyperactive electrical activity, leading to seizures.
✔ Location of the Stroke: Seizures are more common if the stroke occurred in the cortex (outer layer of the brain).
✔ Hemorrhagic Strokes & Large Strokes: Survivors of bleeding strokes (hemorrhagic stroke) or those with severe strokes are at higher risk.
✔ Brain Inflammation or Infection: Post-stroke brain inflammation can increase seizure likelihood.
✔ Chemical Imbalances: Changes in sodium, potassium, or glucose levels after a stroke can trigger seizure activity.

👉 Did You Know?
Seizures can happen immediately after a stroke (within 24 hours) or years later due to long-term brain changes.

When Do Seizures Occur After a Stroke?

Seizures can occur at different times after a stroke, and the timing often determines their impact on long-term recovery.

1. Early-Onset Seizures (Within 7 Days of a Stroke)

• Happen within the first week after a stroke.
• Caused by acute brain injury, inflammation, or swelling.
• Usually don’t lead to epilepsy, but survivors should still be monitored.

2. Late-Onset Seizures (More Than 7 Days After a Stroke)

• Happen weeks, months, or years after a stroke.
• More likely to lead to chronic epilepsy (recurring seizures).
• Caused by brain scarring and long-term damage.

📝 Tip: If you experience even one late-onset seizure, your doctor may diagnose you with post-stroke epilepsy and prescribe treatment.

Types of Seizures Stroke Survivors May Experience

Not all seizures look the same. Some involve uncontrollable body movements, while others cause temporary confusion or staring spells.

1. Focal (Partial) Seizures – Most Common in Stroke Survivors

Focal seizures start in one part of the brain and can cause:

🔹 Simple Partial Seizures (No Loss of Consciousness)

• Twitching or jerking in one limb (arm, leg, or face).
• Tingling, numbness, or unusual sensations.
• Brief moments of deja vu, fear, or confusion.

🔹 Complex Partial Seizures (Altered Awareness)

• Staring blankly or appearing “zoned out.”
• Repetitive movements (lip-smacking, hand movements).
• Confusion or difficulty responding for a few minutes.

2. Generalized Seizures – Less Common but More Severe

These seizures affect the entire brain and usually result in loss of consciousness.

🔹 Tonic-Clonic (Grand Mal) Seizures

• Full-body convulsions with stiffening and jerking.
• Loss of awareness and control.
• Can last 1-2 minutes and lead to exhaustion.

🔹 Absence Seizures (Petit Mal)

• Brief staring spells that last a few seconds.
• No movement or awareness during the episode.

🔹 Atonic Seizures (“Drop Attacks”)

• Sudden loss of muscle control, leading to falling.
• Can cause injury if standing or walking.

How Are Post-Stroke Seizures Diagnosed?

If a stroke survivor experiences seizure-like symptoms, a doctor will run tests to confirm the cause.

Common Tests for Seizures:

✅ Electroencephalogram (EEG): Measures abnormal brain activity.
✅ MRI or CT Scan: Identifies brain damage, scarring, or bleeding.
✅ Blood Tests: Checks for chemical imbalances that may trigger seizures.

If seizures occur more than once, a doctor may diagnose post-stroke epilepsy, requiring long-term treatment.

Treatment Options for Post-Stroke Seizures

Although post-stroke seizures can be scary, they can often be controlled with proper treatment. Here’s how they are managed:

1. Anti-Seizure Medications (Anticonvulsants)

Many stroke survivors only need one medication to control seizures.

✔ Common Seizure Medications:

• Lamotrigine (Lamictal) – Often used for stroke survivors.
• Levetiracetam (Keppra) – Effective with fewer side effects.
• Carbamazepine (Tegretol) – Controls focal seizures.
• Phenytoin (Dilantin) – Used for severe cases.

🔹 Side Effects to Watch For: Fatigue, dizziness, mood changes. If you experience side effects, your doctor may adjust the dose or switch medications.

2. Lifestyle Adjustments to Reduce Seizure Risk

Along with medication, lifestyle changes can lower the chances of future seizures.

✔ Manage Stress & Sleep: Lack of sleep and stress can trigger seizures—try relaxation techniques like deep breathing or meditation.
✔ Eat a Healthy Diet: A well-balanced diet with plenty of protein, healthy fats, and whole grains supports brain function.
✔ Avoid Alcohol & Stimulants: Alcohol and excessive caffeine increase seizure risk.
✔ Stay Hydrated & Watch Blood Sugar Levels: Dehydration and low blood sugar can lead to seizures.

3. Seizure First Aid: What to Do if a Seizure Happens

Knowing what to do if a seizure occurs can prevent injury and improve safety.

✅ Stay Calm & Keep the Person Safe: Move sharp objects away and place them on their side if unconscious.
✅ Time the Seizure: If it lasts more than 5 minutes, call 911.
✅ Do Not Put Anything in Their Mouth: They will not “swallow their tongue.”
✅ Stay with Them Until Fully Awake & Alert.

📝 Tip: If you or a loved one is at risk of seizures, let caregivers and family members know what to do in an emergency.

Final Thoughts: Living Well with Post-Stroke Seizures

Seizures after a stroke can be managed with the right treatment, support, and lifestyle changes.

✔ Work with a neurologist to find the best medication.
✔ Follow a healthy routine to reduce seizure triggers.
✔ Educate family and caregivers on seizure first aid.
✔ Remember that many stroke survivors live full, active lives—even with seizures.

💙 If you or a loved one has experienced post-stroke seizures, know that you’re not alone. With proper care and treatment, seizures can be controlled, and you can continue to enjoy life and recovery.

👉 Have you or a loved one experienced post-stroke seizures? Share your experience or ask questions in the comments below!