Antiseizure medications for post‐stroke epilepsy: A real‐world prospective cohort study

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Title: Antiseizure medications for post‐stroke epilepsy: A real‐world prospective cohort study
Authors: Tomotaka Tanaka, Kazuki Fukuma, Soichiro Abe, Soichiro Matsubara, Rie Motoyama, Masahiro Mizobuchi, Hajime Yoshimura, Takayuki Matsuki, Yasuhiro Manabe, Junichiro Suzuki, Shuhei Ikeda, Naruhiko Kamogawa, Hiroyuki Ishiyama, Katsuya Kobayashi, Akihiro Shimotake, Kunihiro Nishimura, Daisuke Onozuka, Masatoshi Koga, Kazunori Toyoda, Shigeo Murayama, Riki Matsumoto, Ryosuke Takahashi, Akio Ikeda, Masafumi Ihara, for the PROPOSE Study Investigators
Source: Brain and Behavior, Vol 11, Iss 9, Pp n/a-n/a (2021)
Publisher Information: Wiley, 2021.
Publication Year: 2021
Collection: LCC:Neurosciences. Biological psychiatry. Neuropsychiatry
Subject Terms: antiseizure medication, post‐stroke epilepsy, retention, seizure recurrence, tolerability, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
More Details: Abstract Background and purpose The management of post‐stroke epilepsy (PSE) should ideally include prevention of both seizure and adverse effects; however, an optimal antiseizure medications (ASM) regimen has yet been established. The purpose of this study is to assess seizure recurrence, retention, and tolerability of older‐generation and newer‐generation ASM for PSE. Methods This prospective multicenter cohort study (PROgnosis of Post‐Stroke Epilepsy [PROPOSE] study) was conducted from November 2014 to September 2019 at eight hospitals. A total of 372 patients admitted and treated with ASM at discharge were recruited. Due to the non‐interventional nature of the study, ASM regimen was not adjusted and followed standard hospital practices. The primary outcome was seizure recurrence in patients receiving older‐generation and newer‐generation ASM. The secondary outcomes were the retention and tolerability of ASM regimens. Results Of the 372 PSE patients with ASM at discharge (median [IQR] age, 73 [64–81] years; 139 women [37.4%]), 36 were treated with older‐generation, 286 with newer‐generation, and 50 with mixed‐generation ASM. In older‐ and newer‐generation ASM groups (n = 322), 98 patients (30.4%) had recurrent seizures and 91 patients (28.3%) switched ASM regimen during the follow‐up (371 [347–420] days). Seizure recurrence was lower in newer‐generation, compared with the older‐generation, ASM (hazard ratio [HR], 0.42, 95%CI 0.27–0.70; p = .0013). ASM regimen withdrawal and change of dosages were lower in newer‐generation ASM (HR, 0.34, 95% CI 0.21–0.56, p
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2162-3279
Relation: https://doaj.org/toc/2162-3279
DOI: 10.1002/brb3.2330
Access URL: https://doaj.org/article/8fa5595e00bc414db4ba9b09f7f26a1c
Accession Number: edsdoj.8fa5595e00bc414db4ba9b09f7f26a1c
Database: Directory of Open Access Journals
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More Details
ISSN:21623279
DOI:10.1002/brb3.2330
Published in:Brain and Behavior
Language:English