Efficacy, prognosis and causes of recurrent epileptic seizures after antiepileptic drug monotherapy and combination therapy for senile post-stroke seizures

Abstract

Objective To investigate the effect of single antiepileptic drugs(AEDs) and combination therapy on the effect of seizure after stroke, prognosis and recurrent seizures. Methods From November 2013 to December 2017, 280 patients with epilepsy and epilepsy that had been included in the epilepsy course and AEDs course for>6 months in Shaoxing Central Hospital were divided into early-onset epilepsy group and late-onset epilepsy group according to the patients' condition, with 140 cases in each group.According to different AEDs treatment regimens, they were further divided into monotherapy group(valproate) and combination therapy group(valproate, oxcarbazepine combined with levetiracetam). Results The proportion of monotherapy in the early-onset epilepsy group was significantly higher than that of the late-onset epilepsy group, and the proportion of the late-onset epilepsy group was significantly higher than that of the early-onset epilepsy group(χ2=22.857, P<0.0001). The incidence and effectiveness of epilepsy patients after single-agent and combination therapy in the early-onset epilepsy group had statistically significant differences[onset rate: 40.0%(36/90) vs.16.0%(8/50), χ2=8.591, P=0.003; effective rate: 88.9%(80/90) vs.100.0%(50/50), χ2=5.983, P=0.014]. The incidence and effectiveness of single-agent and combination therapy in the late-onset epilepsy group had statistically significant differences [seizure rate: 40.0%(20/50) vs.82.2%(74/90), χ2=25.974, P=0.000; effective rate: 64.0%(32/50) vs.87.8%(79/90), χ2=11.065, P=0.000]. Conclusion The time of post-stroke epilepsy is not related with the site, type and risk factors of stroke; early epilepsy usually manifested partial seizures and had better curative effect of AEDs, and late epilepsy usually manifested overall tonic clonic seizure; there were no obvious difference in curative effect and recurrence rate of early and late epilepsy on single and combined AEDs treatment. Key words: Cerebral stroke; Epilepsy; Anti-epileptic drugs; Prognosis; Aged