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J Korean Neurol Assoc. 2013;31(2):101-107.
- A Survey of the Use of Antiepileptic Drugs in Stroke Patients
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Jinho Lee
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Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
- 신경과, 신경외과 의사를 대상으로 한 뇌졸중 환자에서
항경련제 사용에 대한 설문조사
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이진호, 조원호 박평강 김재형 장우영 김현영 김영서 김희태 김주한
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한양대학교 의과대학 신경과학교실
- Abstract
- Background
Seizures occur in 2-20% of stroke patients. Recent studies have reported that post-stroke seizures are
associated with poorer functional outcomesand higher mortality. However there are no official guidelines on how to use
antiepileptic drugs (AEDs)?in stroke-related seizures. In this study we surveyed neurologists and neurosurgeons and
compared the responses of subgroups categorized by department, specialty and workplace discrimination using a
questionnaire containing questions concerning the present tendency to use AEDs in stroke patients.
Methods
256 neurologists and neurosurgeons participated in the survey. The research instrument was a questionnaire
comprising 9 parts and 30 questions. The questions concerned stroke mechanism, the prophylactic use of AEDs, and the
choice of AED in early and late onset post-stroke seizures.
Results
Tendencies to use prophylactic AEDs in stroke differed depending on?specialty and workplace(neurologist vs.
neurosurgeon; 17.8% vs. 83.1%, p<0.001, hospital vs. university staff; 46.2% vs. 28.4%, p=0.05). The most commonly used
prophylactic AEDs were valproic acid (75%) and levetiracetam (60%). Carbamazepine was the most commonly used AED
and phenytoin and phenobarbital were still used in all subgroups to treat post-stroke seizures.
Conclusions
There are significant differences between neurologists (17.8%) and neurosurgeons (83.1%) in the use of
prophylactic AEDs after stroke. Valproic acid and levetiracetam are considered first-line prophylactic AEDs by
neurosurgeon. Phenytoin and phenobarbital are still used in post-stroke seizure although they have been reported to
have an adverse influence on motor recovery. We suggest that proper guidelines should be established for the use of
AEDs in stroke-related seizures. Key Words: Post-stroke seizure, Survey, Antiepileptic drug
Keywords :
- 초록
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