The effects of Bu Yang Huan Wu Tang on post-stroke epilepsy: a nationwide matched study

Abstract

ObjectiveTo compare the long-term risk of epilepsy in stroke patients who use Bu Yang Huan Wu Tang (BYHWT) and those who do not.MethodsIn the Taiwanese national insurance claims data, we identified newly diagnosed stroke patients receiving inpatient care in the years 2000–2004. Using propensity score-matched pairs to balance the baseline characteristics, we selected eligible stroke patients who did (n=8,971) and did not (n=8,971) receive BYHWT. These two groups were followed up until the end of 2009 to track the occurrence of epilepsy. We used Cox proportional hazard models to calculate the adjusted HRs and 95% CIs for post-stroke epilepsy during the follow-up period according to BYHWT use.ResultsCompared with the control group, stroke patients with BYHWT had a reduced risk of epilepsy during the 5–9 years of the follow-up period (HR 0.69, 95% CI 0.61–0.77). The association between BYHWT and reduced post-stroke epilepsy was significant in various subgroups of stroke patients. There was a dose-dependent decrease in the frequency of epilepsy with increasing quantities of BYHWT use from 1 package (HR 0.77, 95% CI 0.66–0.90) to ≥6 packages (HR 0.52, 95% CI 0.42–0.65).ConclusionStroke patients who received BYHWT therapy had a reduced long-term risk of epilepsy, and the beneficial effect could be observed in various subgroups. However, future clinical trials will be necessary to corroborate the present findings and identify the biochemical mechanism involved.

Early Post-Stroke Seizures: A Comparison Between Acute Ischemic and Haemorrhagic Stroke Patients

“…16 Different studies have reported variations in the rates of post-stroke seizure (from 5-15%) in patients with acute stroke. 17 Our study found no significant statistical difference in post-stroke seizure frequency between the haemorrhagic and ischemic groups. Naydenov et al and Holtkamp et al in their studies, also observed that the type of stroke is not associated with an increased frequency of post-stroke seizure.…”

BYHW Decoction Improves Cognitive Impairments in Rats with Cerebral Microinfarcts via Activation of the PKA/CREB Pathway

“…Clinical studies have also proved the effectiveness of BYHW decoction on stroke [53][54][55]. Furthermore, BYHW decoction also showed beneficial effects on poststroke conditions [56] such as poststroke epilepsy [28], poststroke fatigue [57], and poststroke dementia [58]. The study provides novel evidence that BYHW decoction treatment may help patients with CMIs to gain benefits on recognitive and motor ability.…”

“…A matched study in Taiwan found that stroke patients who received BYHW decoction therapy had a lower longterm risk of epilepsy [24]. Other pharmacodynamic properties of this decoction show positive effects in chronic glomerulonephritis and poststroke epilepsy [27,28]. Despite such success in humans for brain protection, the molecular underpinnings of the therapeutic action of this herbal treatment have not been clearly elucidated and we aimed to investigate this mechanistic question.…”

Incidence and Antiseizure Medications of Post-stroke Epilepsy in Umbria: A Population-Based Study Using Healthcare Administrative Databases

“…The risk of developing PSE seems particularly high after hemorrhagic events, such as SAH and intracerebral hemorrhage, and in younger people. Several studies have reported incidence and/or prevalence of PSE, with estimates ranging widely from 1 to 14% ( 14 , 15 ) in relation to differences in cohort selection and ascertainment. Our estimates are in line with those provided by the largest national-level study based on health insurance database ( n = 270,262), where late seizures were reported in 2.2% of people with stroke ( 16 ).…”