To the Editor.
I read the article by Kieburtz et al1 entitled "Seizures Following Carotid Endarterectomy" with interest, and find it to be a surprising addition to the neurologic literature. There is no doubt that many patients have seizures following carotid endarterectomy (CEA). What one might doubt is the speculation that seizures following CEA may be attributed to "cerebral hyperperfusion, cerebral embolization, or both" as suggested by Kieburtz and colleagues.1 In looking through their experience of 650 CEAs from 1981 through 1987, they found seizures occurring in eight patients, just more than 1%. Olsen et al2 reviewed "Epilepsy After Stroke" and found a 9% incidence of recurrent seizures in a prospective series of 77 consecutive stroke patients. Other studies of epilepsy following stroke were cited: 5% by Aring and Merritt,3 6% by Richardson and Dodge,4 8% by Louis and McDowell,5 6% by Marquardsen,6
Stuart E. Sinoff. Seizures Following Carotid Endarterectomy. Arch Neurol. 1991;48(2):131. doi:10.1001/archneur.1991.00530140019009