抗发作药物用于中风后的初级和二级发作预防
Zoe C Wolcott1, Brin E Freund1, William O Tatum1
1Department of Neurology, Mayo Clinic Florida, Jacksonville, FL, United States.
Frontiers in neurology
|July 23, 2025
概括
脑卒中后发作 (PSS) 和 (PSE) 是中风后的严重并发症. 目前的抗发作药物 (ASM) 使用受到试验数据的限制,需要个性化治疗策略以获得更好的结果.
科学领域:
- 神经学 神经学
- 脑血管疾病 脑血管疾病
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 脑卒中后发作 (PSS) 和 (PSE) 是脑血管疾病的重要并发症,增加了发病率和死亡率.
- 随着中风存活率的提高,PSS的发病率正在上升.
- 风险因素包括皮质干涉,中风严重程度和早期发作.
研究的目的:
- 审查目前在PSS中使用抗发作药物 (ASM) 的方法.
- 强调在PSS和PSE中进行ASM启动和停止的临床决策.
- 突出改善证据和个性化治疗策略的需要.
主要方法:
- 本小评论总结了关于ASM在PSS中的使用现有的文献和临床指南.
- 它侧重于风险分层,初级与二级预防,以及ASM选择.
- 该审查讨论了管理已建立的PSE的挑战,以及对生物标志物的需求.
主要成果:
- 缺乏高质量的试验,评估ASM在PSS中的有效性和安全性.
- 拉莫特里金和 levetiracetam 被认为是合理的第一线ASM.
- 个性化的ASM选择至关重要,特别是在老年人或患有并发症的人群中.
结论:
- 目前在PSS中使用ASM的指导是有限的证据,需要谨慎的临床决策.
- 有效管理PSS和PSE需要进一步的研究,包括高质量的试验和预测模型.
- 个性化治疗策略对于优化中风后发作患者的治疗结果至关重要.
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