Abstract
Objectives: To describe the clinical characteristics, electroencephalographic findings, and magnetic resonance imaging features in patients with late-onset epilepsy following supratentorial cerebral infarction. Methods: A cross-sectional descriptive study combined with retrospective data collection was conducted on 46 patients diagnosed with late-onset epilepsy after supratentorial cerebral infarction treated at the Bach Mai Neurology Institute - Bach Mai Hospital from June 2024 to January 2026. Clinical characteristics, electroencephalographic findings, and brain magnetic resonance imaging results were collected and analyzed using descriptive statistical methods and appropriate statistical tests. Results: The mean age of patients was 68.6 ± 10.6 years, with the majority aged over 60 years (78.3%); males accounted for 63%. Focal to bilateral tonic–clonic seizures were the most common type (47.8%), followed by generalized seizures (34.8%). EEG abnormalities were observed in 69.6% of patients, predominantly focal slowing. On brain MRI, cortical lesions accounted for 43.5%, while combined cortical–subcortical lesions accounted for 37.0%. Cortical involvement was significantly associated with EEG abnormalities (p < 0.048). No statistically significant differences were found in clinical features, EEG, or imaging findings between age groups (p > 0.05). Conclusion: Late-onset epilepsy after supratentorial ischemic stroke predominantly occurs in elderly patients, with focal-onset seizures being the most common presentation. Cortical lesions are associated with EEG abnormalities. The combined assessment of clinical features, EEG, and MRI findings plays an important role in the diagnosis and prognostic evaluation of these patients.
