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17-06-2022 | Stroke | Original Article

Anti-seizure medication treatment and outcomes in acute ischemic stroke patients undergoing continuous EEG monitoring

Authors: Paula R. Sanches, Mohammad Tabaeizadeh, Lidia M. V. R. Moura, Eric S. Rosenthal, Luis Otavio Caboclo, John Hsu, Elisabetta Patorno, M. Brandon Westover, Sahar F. Zafar

Published in: Neurological Sciences | Issue 9/2022

Abstract

Objectives

To determine the association of anti-seizure medication (ASM) treatment with outcomes in acute ischemic stroke (AIS) patients undergoing continuous electroencephalography (cEEG).

Methods

Retrospective analysis of AIS patients admitted between 2012 and 2019. The following are the inclusion criteria: age ≥ 18 years and ≥ 16 h of cEEG within the first 7 days of admission. ASM treatment exposure was defined as > 48 h of treatment after the first 24 h of cEEG. The primary outcome measure was 90-day mortality, and the secondary outcome was 90-day functional recovery (Modified Ranking Scale 0–3). Propensity scores were used to adjust for baseline covariates and presence of epileptiform abnormalities (seizures, periodic and rhythmic patterns).

Results

One hundred thirteen patients met the inclusion criteria; 39 (34.5%) were exposed to ASM. ASM treatment was not associated with 90-day mortality (propensity adjusted HR 1.0 [0.31–3.27], p = 0.999) or functional outcomes (adjusted HR 0.99 [0.32–3.02], p = 0.989), compared to no treatment.

Conclusions

In our study, ASM treatment in AIS patients with cEEG abnormalities was not significantly associated with a change in 90-day mortality and functional recovery. Larger comparative effectiveness studies are indicated to identify which acute ischemic stroke patients with cEEG abnormalities benefit most from ASM treatment.

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Title: Anti-seizure medication treatment and outcomes in acute ischemic stroke patients undergoing continuous EEG monitoring
Authors: Paula R. Sanches
Mohammad Tabaeizadeh
Lidia M. V. R. Moura
Eric S. Rosenthal
Luis Otavio Caboclo
John Hsu
Elisabetta Patorno
M. Brandon Westover
Sahar F. Zafar
Publication date: 17-06-2022
Publisher: Springer International Publishing
Keyword: Stroke
Published in: Neurological Sciences / Issue 9/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-06183-9

At a glance: The STEP trials

Springer Medicine

Anti-seizure medication treatment and outcomes in acute ischemic stroke patients undergoing continuous EEG monitoring

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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