One hundred and seventy-three patients with ischemic brain lesion and steno-occlusive process who have different types of epileptic seizures have been studied. The seizures have developed in 51,5% of patients after ischemic stroke and in 48,5% of patients with chronic brain ischemia. Electroencephalography, magnetic-resonance tomography, transcranial dopplerography, a duplex study of intracranial cerebral vessels with functional tests and extracranial dopplerography have been conducted along with a neurological examination. Focal seizures were the most prevalent in patients with lesions of the right carotid bed. There was the dissociation of localization of ischemic zones with epileptiform foci recorded more often in the left hemisphere. Clinical-functional-neuroimaging patterns depended on the time of the vascular catastrophe. The feature of brain ischemic disease was the change of cerebrovascular reactivity in the vertebrobasilar bed that reflected the insufficiency of perfusion reserve. This fact may suggest the imbalance and insufficiency of antiepileptic system.