Disparities in the Use of Seizure Medications After Intracerebral Hemorrhage

Abstract

Background and Purpose-We investigated potential disparities in the use of prophylactic seizure medications in patients with intracerebral hemorrhage.

Prophylactic Seizure Medication and Health-Related Quality of Life After Intracerebral Hemorrhage

“…Patients with ICH do not indiscriminately receive levetiracetam, rather, treatment is generally given to patients at elevated risk for seizures due to lobar hematoma location,(3, 24) and a correspondingly higher CAVE Score. Controlling for lobar hematoma in statistical models was not statistically significant and did not change the association of prophylactic levetiracetam with worse cognitive function HRQoL.…”

Scoping Review of Racial, Ethnic, and Sex Disparities in the Diagnosis and Management of Hemorrhagic Stroke

“…28 An analysis of 3,422 patients from a multicenter prospective cohort found that White patients were twice as likely as Black patients to receive seizure prophylaxis after ICH, but the association was eliminated in a single-center subset controlling for hematoma location. 29…”

“…28 An analysis of 3,422 patients from a multicenter prospective cohort found that White patients were twice as likely as Black patients to receive seizure prophylaxis after ICH, but the association was eliminated in a single-center subset controlling for hematoma location. 29 No studies evaluated for disparities in the application of continuous EEG or utilization of antiseizure medications after seizure. Sex disparities in the utilization of antiseizure medications after ICH have not been investigated.…”

In reply:

“…2 That said, the individual studies permit differentiation of patients according to bleeding anatomy. 3 It would be a compelling addition to the literature to examine whether there is any effect modification for antiepileptic effect related to bleeding location.…”

“…To the Editor: Olfactory loss as a symptom of coronavirus disease 2019 (COVID-19) has been receiving increasing attention globally, with a number of international statements including it as a key symptom of the disease. [1][2][3][4] In response, the emergency department (ED) at Sengkang General Hospital, a tertiary care hospital in Singapore, began actively inquiring about acute olfactory loss (hyposmia or anosmia of less than 14 days' duration) from April 23, 2020, for all patients who presented with…”