|
KMID : 0359720130310020101
|
|
Journal of the Korean Neurological Association
2013 Volume.31 No. 2 p.101 ~ p.107
|
|
|
A Survey of the Use of Antiepileptic Drugs in Stroke Patients
|
|
Lee Jin-Ho
Jho Won-Ho
Park Pyeong-Kang
Kim Jae-Hyung
Jang Woo-Young
Kim Hyun-Young
Kim Young-Seo
Kim Hee-Tae
Kim Ju-Han
|
|
|
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.
|
|
|
KEYWORD
|
|
|
Post-stroke seizure, Survey, Antiepileptic drug
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|