Antiepileptic drugs for the primary and secondary prevention of seizures after stroke

Sykes, Lucy; Wood, Emma; Kwan, Joseph

doi:10.1002/14651858.cd005398.pub3

Cited by 53 publications

(42 citation statements)

References 38 publications

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“…However, this would only be true for the specific young stroke population they studied, since in our study the relation between LS and mortality was not significant. Before starting studies aimed at prophylactic treatment with antiepileptic drugs in stroke patients, more effort should be done to elaborate the exact influence of LS in stroke patients, not only with regard to mortality but also concerning the effect on stroke recovery and quality of life [34]. …”

Section: Discussionmentioning

confidence: 99%

The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study

et al. 2018

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ObjectiveEpileptic seizures are a common complication after stroke. The relation between occurrence of seizures after stroke and long-term mortality remains elusive. We aimed to assess whether seizures in an early or late phase after ischemic stroke are an independent determinant of long-term mortality.MethodsWe prospectively included and followed 444 ischemic stroke patients with a first-ever supratentorial brain infarct for at least 2 years after their stroke regarding the occurrence of seizures. The final follow-up for mortality is from April 2015 (follow-up duration 24.5–27.8 years, mean 26.0 years, SD 0.9 years). We compared patients with early-onset seizures with all seizure-free patients, whereas the patients with late-onset seizures were compared with the 1-week survivors without any seizures. We used Cox-regression analyses to correct for possible confounding factors.ResultsKaplan–Meier analysis showed significantly higher mortality for the patients with early-onset seizures (p = 0.002) but after correction for known risk factors for (long term) mortality early-onset seizures had no independent influence on long-term mortality (HR 1.09; 95% CI 0.64–1.85). In patients with late-onset seizures, no significant influence from late-onset seizures on long-term mortality was found (univariate p = 0.717; multivariate HR 0.81; 95% CI 0.54–1.20).ConclusionBoth early-onset and late-onset seizures do not influence long-term mortality after ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study

et al. 2018

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“…42 However, in many hospitals worldwide, the use of antiepileptic drugs as a prophylactic intervention in ICH patients is a common practice. According to the new definition of epilepsy, in the presence of a cortical lesion, 1 seizure is adequate for diagnosis of epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Association between Seizures and Outcomes among Intracerebral Hemorrhage Patients: The China National Stroke Registry

Zhao

Wang

et al. 2015

Journal of Stroke and Cerebrovascular Diseases

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“…Additionally, there are no recent randomized controlled trials that would answer the question whether antiepileptic drugs (AEDs) have any benefit for primary and secondary prevention of post-ischemic stroke seizures. 26 Seizures thus remain a problematic complication of stroke due to their unpredictability, unclear effect on prognosis, and lack of specific treatment guidelines.…”

Section: Introductionmentioning

confidence: 99%

Seizures Following Ischemic Stroke: Frequency of Occurrence and Impact on Outcome in a Long-Term Population-Based Study

Bryndziar

Šedová

Kramer

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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Background & Purpose Seizures are a known complication of ischemic stroke. This study assesses the long-term incidence and characteristics of post-stroke seizures in a well-defined population. Methods Utilizing the Rochester Epidemiology Project medical record linkage system, we identified all incident cases of ischemic stroke (IS) among Rochester, MN residents from 1990-1994, and followed the patients in the comprehensive medical record through March 2014. All patients with post-stroke seizures were identified, and data regarding incident IS, seizures, and status at last follow-up were analyzed. Results We identified 489 patients with first IS. Mean follow-up was 6.5 (SD 6.3) years. New onset seizures occurred in 35 patients (7.2%). Patients with post-stroke seizure did not differ from those without in terms of IS etiologic subtype (p=0.44) or IS risk factors (p>0.05). Early seizures (within 14 days of index stroke) developed in 14 patients (40%), the majority within the first 24 hours (n=9; 64.3%). The median time of seizure onset for the remaining 21 patients was 13.8 months. Functional outcome, as measured by modified Rankin scale, was worse following development of post-stroke seizures (mean mRS 2.9 after IS, 3.3 following index seizure; p=0.005), and mortality was higher as well, even after adjusting for IS etiologic subtype (HR 1.52; 95% CI 1.07-2.16; p=0.02). Conclusion Development of post-stroke seizures is an infrequent, but significant complication of ischemic stroke, portending a worse short-term functional outcome and a higher long-term mortality rate. Seizure occurrence did not differ based on IS etiologic subtype or stroke risk factors.

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Antiepileptic drugs for the primary and secondary prevention of seizures after stroke

Cited by 53 publications

References 38 publications

The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study

The occurrence of seizures after ischemic stroke does not influence long-term mortality; a 26-year follow-up study

Association between Seizures and Outcomes among Intracerebral Hemorrhage Patients: The China National Stroke Registry

Seizures Following Ischemic Stroke: Frequency of Occurrence and Impact on Outcome in a Long-Term Population-Based Study

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