Related Experiment Video
Updated: Jan 12, 2026
Electrophoretic Delivery of γ-aminobutyric Acid GABA into Epileptic Focus Prevents Seizures in Mice
Published on: May 16, 2019
Anti-seizure medications in patients with post-stroke epilepsy: A survival analysis study
Ippazio Cosimo Antonazzo1,2,3,4, Carla Fornari1, Gabriele Buongarzone1
1Research Centre on Public Health (CESP), University of Milano-Bicocca, Monza, Italy.
Objective:
The role of antiseizure medications (ASMs) in patients with post-stroke epilepsy (PSE) is still debated. Although a few studies have compared the efficacy of different ASMs on mortality in patients with PSE, overall evidence on the impact of ASM use on survival is limited. This study aimed to evaluate the association between ASM use and all-cause mortality in patients with PSE.
Methods:
A cohort study was conducted using health care administrative database of Health Protection Agency of Bergamo (Italy). Individuals with a diagnosis of stroke followed by epilepsy onset between January 1, 2014 and December 31, 2017 were included. The date of epilepsy was considered as Index date (ID). Patients were followed from the ID until death, disenrollment, or end of follow-up, whichever occurred first. Exposure to ASMs was defined as at least one dispensing within 30 days of the ID; patients without ASM dispensing during this period were considered non-exposed. All-cause mortality was analyzed using Cox proportional hazards models, with non-exposure as the reference. Two analytical approaches were adopted: an intention-to-treat analysis and a time-dependent analysis.
Results:
A total of 145 patients met the inclusion criteria: 107 ASM users and 38 non-users. In the intention-to-treat analysis, ASM use was associated with a lower risk of all-cause mortality (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.33-0.95). Consistent findings were observed in the time-dependent analysis (adjusted HR: 0.39; 95% CI: 0.23-0.65). The sensitivity analyses confirmed the robustness of the results.
Significance:
In this population-based cohort study, ASM use in patients with PSE was associated with a significantly reduced risk of all-cause mortality compared to non-use. These findings support the hypothesis that ASM treatment might be associated with positive effect in this high-risk population.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...
01:08Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
01:17Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...