TITLE:
Therapeutic and Prognostic Aspects of Vascular Epilepsy in Neurology Departments: A 4-Year Descriptive Study Conducted at the Treichville University Hospital and a Private Medical Center in Abidjan
AUTHORS:
N’Guessan Yves Constant Broh, Kouamé Loeonard Kouassi, Donissongui Soro, Ange Stephane Abbé, Tanya Nancy Essoin-De Souza, Affoue Marie Roxane Beuseize, Nawa Samuel Yéo, Ismaila Diakité, Mariam Doumbia-Ouattara
KEYWORDS:
Vascular Epilepsy, Stroke, Levetiracetam, Antiepileptic Treatment, Ivory Coast
JOURNAL NAME:
Open Journal of Pathology,
Vol.16 No.4,
October
21,
2026
ABSTRACT: Introduction: Vascular epilepsy, defined as the recurrence of epileptic seizures following a stroke, is the leading cause of late-onset epilepsy in adults. In sub-Saharan Africa, its incidence is rising in parallel with that of cardiovascular diseases, posing a major therapeutic challenge. Objective: To analyze the therapeutic aspects and clinical course of vascular epilepsy at Treichville University Hospital and at a private medical center in Abidjan (Ivory Coast). Materials and Methods: This is a retrospective descriptive study conducted over a 4-year period from January 2022 to December 2025 at Treichville University Hospital and a private medical center in Abidjan. The study examined the medical records of patients followed for vascular epilepsy. Patients with acute symptomatic seizures (seizures occurring within the first 7 days following a stroke and not persisting beyond 7 days) were excluded, as were incomplete records that did not allow for a definitive diagnosis of vascular epilepsy. Data collection and analysis were performed using the KoboToolbox application. Quantitative variables (age) were expressed as means and standard deviations, and other qualitative variables as frequencies and percentages. Verbal consent was obtained from patients or their families, guaranteeing anonymity and confidentiality. Results: A total of 53 patients were included, including 31 patients at Treichville University Hospital. The mean age was 58.45 years ± 14.03 years, with a predominance of males (male-to-female ratio of 1.65). Ischemic stroke accounted for 83.02% of cases (n = 44) and hemorrhagic stroke for 16.98% (n = 9). The strokes presented with a focal onset in 71% of cases (n = 38). The most frequently prescribed antiepileptic drugs were levetiracetam (28.30%, n = 15), sodium valproate (16.98%, n = 9), carbamazepine (15.09%, n = 8), and phenobarbital (13.21%, n = 7). Therapeutic efficacy (defined as a >50% reduction in seizures for more than 6 months) was observed in 60.38% of patients (n = 32), and seizure remission (absence of seizures) in 62.26% (n = 33), of whom 36.36% (n = 12 out of 33) experienced remission lasting up to 24 months. Reported adverse effects included drowsiness (7.55%, n = 4) and psychiatric disorders (3.77%, n = 2). The persistence of seizures was mainly due to poor adherence (18.87%, n = 10), loss to follow-up (7.54%, n = 4), and the high cost of treatment (3.77%, n = 2), with some patients having multiple overlapping causes. Conclusion: The management of vascular epilepsy in Abidjan illustrates a therapeutic transition marked by the emergence of new-generation medications (levetiracetam) alongside conventional treatments. Although overall efficacy is satisfactory, non-adherence and financial cost remain the main obstacles to long-term seizure control.