A Survey of the Use of Antiepileptic Drugs in Stroke Patients.
- Author:
Jinho LEE
1
;
Wonho JHO
;
Pyeong Kang PARK
;
Jaehyung KIM
;
Wooyoung JANG
;
Hyun Young KIM
;
Young Seo KIM
;
Hee Tae KIM
;
Juhan KIM
Author Information
1. Department of Neurology, Hanyang University College of Medicine, Seoul, Korea. kimjuhan@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Post-stroke seizure;
Survey;
Antiepileptic drug
- MeSH:
Anticonvulsants;
Carbamazepine;
Discrimination (Psychology);
Humans;
Phenobarbital;
Phenytoin;
Piracetam;
Surveys and Questionnaires;
Seizures;
Stroke;
Valproic Acid
- From:Journal of the Korean Neurological Association
2013;31(2):101-107
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Seizures occur in 2-20% of stroke patients. Recent studies have reported that post-stroke seizures are associated with poorer functional outcomesand higher mortality. However there are no official guidelines on how to use antiepileptic drugs (AEDs) in stroke-related seizures. In this study we surveyed neurologists and neurosurgeons and compared the responses of subgroups categorized by department, specialty and workplace discrimination using a questionnaire containing questions concerning the present tendency to use AEDs in stroke patients. METHODS: 256 neurologists and neurosurgeons participated in the survey. The research instrument was a questionnaire comprising 9 parts and 30 questions. The questions concerned stroke mechanism, the prophylactic use of AEDs, and the choice of AED in early and late onset post-stroke seizures. RESULTS: Tendencies to use prophylactic AEDs in stroke differed depending on specialty and workplace(neurologist vs. neurosurgeon; 17.8% vs. 83.1%, p<0.001, hospital vs. university staff; 46.2% vs. 28.4%, p=0.05). The most commonly used prophylactic AEDs were valproic acid (75%) and levetiracetam (60%). Carbamazepine was the most commonly used AED and phenytoin and phenobarbital were still used in all subgroups to treat post-stroke seizures. CONCLUSIONS: There are significant differences between neurologists (17.8%) and neurosurgeons (83.1%) in the use of prophylactic AEDs after stroke. Valproic acid and levetiracetam are considered first-line prophylactic AEDs by neurosurgeon. Phenytoin and phenobarbital are still used in post-stroke seizure although they have been reported to have an adverse influence on motor recovery. We suggest that proper guidelines should be established for the use of AEDs in stroke-related seizures.
