A Survey of the Use of Antiepileptic Drugs in Stroke Patients
Journal of the Korean Neurological Association
;
: 101-107, 2013.
Article
in Korean
| WPRIM
| ID: wpr-162906
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Phenobarbital
/
Phenytoin
/
Piracetam
/
Seizures
/
Carbamazepine
/
Surveys and Questionnaires
/
Valproic Acid
/
Stroke
/
Discrimination, Psychological
/
Anticonvulsants
Type of study:
Qualitative research
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Neurological Association
Year:
2013
Type:
Article
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