Management of seizures following a stroke: what are the options?
作者： Ronit Gilad
DOI: 10.2165/11631540-000000000-00000
关键词:
摘要: Post-stroke seizures are a frequent cause of remote symptomatic epilepsy in adults, especially older age. About 10% stroke patients will suffer seizure, depending on risk factors, such as the type, location and severity stroke. Previous accounts for 30-40% all cases elderly. Compared with that younger patients, appearance old age is less specific may take time before diagnosis can be proven. The optimal timing type antiepileptic drug (AED) treatment post-stroke still controversial issue. Many population- hospital-based studies have been performed, ending generalized recommendations, but decision to initiate AED after first or second seizure should individualized. Prospective literature showed immediate unprovoked does not improve long-term remission rate. However, because physical psychological influences recurrent seizures, prophylactic considered event an elderly person at high recurrence, taking into consideration individuality patient discussion his/her family about risks benefits both options. latest regarding 'new-generation' drugs, lamotrigine, gabapentin levetiracetam, low doses would reasonable their rate seizure-free periods, improved safety profile, fewer interactions other anticoagulant ones, compared first-generation AEDs. On hand, phenytoin, carbamazepine phenobarbital, potential harmful impact recovery, bone health, cognition blood sodium levels interact treatments used by population. chosen use population possess wide spectrum activity few side effects. An assessment done identify possible drug-drug interactions, started dose titrated slowly lowest maintenance possible, enhanced quality life focus treatment. So, end, further research needed determine, more appropriately, therapy, duration
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