Posts Tagged post-stroke epilepsy

[Abstract] No prevention or cure of epilepsy as yet – Invited review

Highlights

  • Approximately 20% of all epilepsy is caused by acute acquired injury such as traumatic brain injury, stroke and CNS infection, with potential to prevent epilepsy
  • No treatment to prevent acquired epilepsy exists; and very few clinical studies have been done during the last 15 years to develop such treatment
  • We review possible reasons for this, possible ways to rectify the situations and note some of the ways currently under way to do so
  • We further review “cures” of epilepsy that occur spontaneously, and after surgical and sometimes medical antiseizure treatments. We note the limited understanding of the mechanisms of such remissions and thus, at present inability to replicate them with targeted therapy

Abstract

Approximately 20% of all epilepsy is caused by acute acquired injury such as traumatic brain injury, stroke and CNS infection. The known onset of the injury which triggers the epileptogenic process, early presentation to medical care, and a latency between the injury and the development of clinical epilepsy present an opportunity to intervene with treatment to prevent epilepsy. No such treatment exists and yet there has been remarkably little clinical research during the last 20 years to try to develop such treatment. We review possible reasons for this, possible ways to rectify the situations and note some of the ways currently under way to do so.

Resective surgical treatment can achieve “cure” in some patients but is sparsely utilized. In certain “self-limiting” syndromes of childhood and adolescence epilepsy remits spontaneously. In a proportion of patients who become seizure free on medications or with dietary treatment, seizure freedom persists when treatment is discontinued. We discuss these situations which can be considered “cures”; and note that at present we have little understanding of mechanism of such cures, and cannot therefore translate them into a treatment paradigm targeting a “cure” of epilepsy.

via No prevention or cure of epilepsy as yet – ScienceDirect

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[Abstract] Post-stroke epilepsy

Highlights

Post-stroke epilepsy (PSE) is a major complication after stroke.

It is unclear which treatments are most effective in the prevention of recurrence of symptoms, or whether such therapy is needed for primary prevention.

The current understanding of epidemiology, diagnoses, mechanisms, risk factors, and treatments of PSE are covered in this review.

Abstract

Post-stroke epilepsy (PSE) is a common complication after stroke, yet treatment options remain limited. While many physicians prescribe antiepileptic drugs (AED) for secondary prevention of PSE, it is unclear which treatments are most effective in the prevention of recurrence of symptoms, or whether such therapy is needed for primary prevention. This review discusses the current understanding of epidemiology, diagnoses, mechanisms, risk factors, and treatments of PSE.

Source: Post-stroke epilepsy

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[WEB SITE] Statins Reduce Post-Stroke Seizure Risk

Taking a statin after a stroke, especially in the acute phase, reduces the risk for early-onset seizures and may prevent the progression of these seizures to chronic epilepsy, new research suggests.

The study, led by Jiang Guo, MD, Department of Neurology, West China Hospital of Sichuan University, Chengdu, China, was published online July 22 in Neurology.

Statins, typically used to treat high cholesterol and atherosclerotic diseases, are effective in both primary and secondary prevention of coronary heart disease and stroke, the authors write. These drugs are often given during the acute phase of a stroke.

The current analysis, a cohort study, included 1832 patients (mean age, 64.3 years) who had no history of epilepsy and were admitted to the Western China Hospital between January 2010 and August 2013 with a first-ever ischemic stroke.

Researchers used the National Institute of Health Stroke Scale (NIHSS) to categorize stroke severity as mild (less than 7), moderate (7 to 25) or severe (>25). They classified statin use into two phases: before the stroke (regular use at least 1 month before stroke) or in the acute phase (initiated within 3 days after stroke onset and continuing for at least 3 days).

In follow-up phone or face-to-face interviews, patients were asked about experiencing a seizure-like event or being diagnosed with epilepsy.

The primary outcomes were post-stroke early-onset seizure (ES) and post-stroke epilepsy (PSE). Acute ES was within 7 days of the stroke, and unprovoked late-onset seizures were more than 7 days after the stroke. PSE was defined as 2 or more unprovoked late-onset epileptic seizures after the acute phase of the stroke. Seizures were categorized as partial (simple, complex, and secondary generalized) and generalized.

Of the total sample, 14 patients used a statin before the stroke only, 1277 used a statin only in the acute phase, 114 used a statin before the stroke and in the acute phase, and 427 did not use a statin before the stroke or in the acute phase.

Continue —>  Statins Reduce Post-Stroke Seizure Risk.

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