Incidence and Factors Associated With More Than One Antiseizure Medications in Poststroke Epilepsy: A Single-Center Study

Abstract

Background: People with epilepsy are burdened with consequence of seizures, especially in drug resistant epilepsy. However, patients with poststroke epilepsy (PSE) who were mostly elderly and faced more seizures were affected not only by functional decline but also had no abundant time for antiseizure medication (ASM) trials. Objective: To assess the incidence and factors associated with more than one ASMs in patients with PSE. Methods: A retrospective chart review study was evaluated in 136 patients with a stroke onset following seizure with admission, who fulfilled the poststroke epilepsy diagnosis from January 2016 to June 2023. Then, they were categorized into only one and more than one ASMs groups to analyze. Results: The incidence rate of patients with more than one ASMs in PSE was 89.0 persons and drug resistant PSE was 16.7 persons/1000 person-years. The median time to follow was 30 months and seizure latency was 7 months. The hemorrhagic stroke type was a factor associated with more than one ASMs compared with ischemic stroke (OR, 2.77; 95% CI, 1.23 - 6.23; P = .01). There was a multicollinearity effect in hemorrhagic stroke with cranial surgery during stroke events and underlying atrial fibrillation. Conclusions: More than one ASMs in patients with PSE were applied in neurological practices per the incidence. Moreover, the hemorrhagic stroke was found to be associated with more than one ASMs.