Under what circumstances will a stroke patient have a “stroke”?

  The scientific name for “convulsions” is epilepsy. There are various forms of epilepsy, such as grand mal seizures with generalized convulsions and loss of consciousness, commonly known as “epilepsy”; focal epilepsy with partial body convulsions; psychomotor epilepsy characterized by abnormal psychiatric behavior; and petit mal seizures with loss of consciousness (dazed) as the main symptom. …… Regardless of the form, epilepsy is characterized by sudden onset and abrupt termination. Most patients maintain only one fixed form of recurrent seizures, and a few may have more than two forms of seizures.  Epilepsy is triggered by abnormal bioelectrical activity in the brain. In addition to congenital factors, severe disturbance of brain function by brain lesions or systemic diseases, especially when they pose a stimulus to the cerebral cortex, may cause epilepsy. Strokes that produce lesions in the brain, whether hemorrhage or infarction, are in general uncommon in epilepsy because most are located deep in the brain. However, in a few cases, stroke lesions in the cerebral cortex or subcortex can still cause seizures. For example, cerebral embolism occurs mostly in cortical or subcortical areas, and together with the disease, seizures can occur. Another example is subarachnoid hemorrhage, which can also be seen as a seizure if the hemorrhage site is on the surface of the brain. Cerebral hemorrhage can only occur when the hemorrhage is superficial or cortical. As for cerebral thrombosis, it is usually seen in large cerebral infarcts involving cortical or subcortical sites, and seizures tend to occur in the recovery and posterior phases.  Focal seizures and grand mal seizures are the most common forms of seizures in stroke patients. The former often manifests as hemiplegic convulsions on the contralateral side of the brain lesion during seizures, with mostly clear consciousness; the latter is a generalized convulsion with most of the loss of consciousness. The convulsions are episodic and last for several minutes, but can be repeated with little regularity in their intervals. In some patients, the convulsions are continuous and the consciousness is not restored by the grand mal, which is called persistent status epilepticus. Focal status epilepticus is common in stroke patients, and it is a difficult symptom to control.