Efficacy and safety of antiseizure medication in post-stroke epilepsy

Winter, Yaroslav; Uphaus, Timo; Sandner, Katharina; Klimpe, Sven; Stuckrad-Barre, Sebastian von; Groppa, Sergiu

doi:10.1016/j.seizure.2022.07.003

Cited by 11 publications

(8 citation statements)

References 29 publications

(28 reference statements)

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“…25 Interestingly, this observation was also made for lacosamide, which has the same mechanism of action. 25 These findings may lead to improved treatment of poststroke epilepsy and to a significant increase in patients' health-related quality of life. 26,27 A logistic regression analysis of our data showed that the number of days spent with SE before the start of ESL is an independent predictor of interruption of SE, with better outcomes in the case of earlier initiation of ESL.…”

Section: Others (Tumor Post-traumatic Neurodegenerative)mentioning

confidence: 72%

“…The mechanism of action of ESL, i.e., slow inactivation of sodium channels, may play a role in an improved response of patients with poststroke epilepsy 25 . Interestingly, this observation was also made for lacosamide, which has the same mechanism of action 25 . These findings may lead to improved treatment of poststroke epilepsy and to a significant increase in patients' health‐related quality of life 26,27 …”

Section: Discussionmentioning

confidence: 94%

“…This relates to a higher responder rate, which is defined as a seizure reduction of ≥50%, as well as a more frequent seizure freedom rate at ≥3 months in patients with poststroke epilepsy and ESL therapy 24 . The mechanism of action of ESL, i.e., slow inactivation of sodium channels, may play a role in an improved response of patients with poststroke epilepsy 25 . Interestingly, this observation was also made for lacosamide, which has the same mechanism of action 25 .…”

Section: Discussionmentioning

confidence: 99%

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Eslicarbazepine acetate for the treatment of status epilepticus

Winter

Sandner

Vieth

et al. 2023

Epileptic Disorders

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Objective: Due to the high mortality of patients with refractory status epilepticus (SE), new antiseizure medications (ASMs) are needed to improve long-term outcomes. In this study, we evaluated the efficacy and safety of eslicarbazepine acetate (ESL), a new sodium channel blocker, based on the data from a large epilepsy register.Methods: Data on the efficacy and safety of ESL for the treatment of refractory SE were gathered from the Mainz Epilepsy Registry (MAINZ-EPIREG). Logistic regression was applied to identify predictors of status interruption.Results: In total, 64 patients with remote symptomatic refractory SE were treated with ESL. No cases of idiopathic generalized epilepsy were included. The average age was 61.4 ± 11.0 years. The median number of administered ASMs before the start of ESL was three. On average, 2 days had elapsed since the onset of SE before the administration of ESL. The initial dose of 800 mg/day was increased up to a maximum daily dose of 1600 mg in case of nonresponse. In 29 of 64 patients (45.3%), the SE could be interrupted within 48 h of ESL therapy. In patients with poststroke epilepsy, the control of SE was achieved in 62% of patients (15/23). The earlier initiation of ESL therapy was an independent predictor of control of SE. Hyponatraemia occurred in five patients (7.8%). Other side effects were not observed.Significance: Based on these data, ESL may be used as an adjunct therapy for the treatment of refractory SE. The best response was found in patients with poststroke epilepsy. In addition, early initiation of ESL therapy appears to result in better control of SE. Besides a few cases of hyponatraemia, no other adverse events were detected. K E Y W O R D Sefficacy, eslicarbazepine acetate, hyponatraemia, poststroke epilepsy, safety, status epilepticus | INTRODUCTIONStatus epilepticus (SE) is a neurological emergency causing both high morbidity and mortality unless prompt and effective treatment is administered. 1 Excessive neuronal discharges lead to epileptiform potentials inducing brain damage and secondary systemic complications. Alterations at the molecular, cellular, synaptic, andThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Section: Others (Tumor Post-traumatic Neurodegenerative)mentioning

confidence: 72%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Eslicarbazepine acetate for the treatment of status epilepticus

Winter

Sandner

Vieth

et al. 2023

Epileptic Disorders

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“…Some scholars have pointed out that the combination of sodium valproate and lamotrigine has an obvious effect, and the reason may be that the combined drug can inhibit the abnormal discharge of neurons. Half-life of triazine has been prolonged, the blood concentration of the drug has been increased, and the efficacy of the drug has been improved [13] . Wang et al [14] pointed out that high doses of sodium valproate can better control epileptic discharges and improve cognitive function in children.…”

Section: Resultsmentioning

confidence: 99%

Comparative Study on the Effect and Influence of Sodium Valproate and Perampanel on Nerve Damage and Cognitive Function in Epilepsy

Chen,

Feng

2024

IJPS

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Role of Sodium Valproate and Perampanelin in EpilepsyThis study compared the efficacy of sodium valproate and perampanel in the treatment of children with epilepsy and their effects on nerve damage and cognitive function. 68 individuals were divided into group A and group B, each with 34 individuals. On the basis of rehabilitation training, group A received sodium valproate treatment, while group B received perampanel treatment. By comparing the duration of epileptic seizures, seizure frequency, blood drug concentration, therapeutic effect, nerve damage and cognitive function, and incidence of adverse drug effects both the groups, impact of the two drugs on the children were evaluated. After medication, the duration and frequency of seizures in the two groups were lower than those before medication, but the duration and frequency of seizures in the sodium valproate group were lower (p<0.05). The blood concentration of group A was lower than that of group B (p<0.05) and there was no significant difference in treatment effect between both the groups (p>0.05). The medication of the two groups had an effect on the nerve injury and cognitive function of the children, and there was no significant difference in comparison (p>0.05). There was no significant difference in the incidence of drug adverse events between the two groups (p>0.05). Both sodium valproate and perampanel have a good curative effect on children with epilepsy, and the drug safety is high. Further, both the drugs effect on the nerve damage and cognitive function of children, but sodium valproate seems to be more effective and is worth recommending for medication.

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“…The enhancement of slow inactivation of voltage-gated sodium channels, which is a common mechanism of action in both LCS and ESL, is obviously effective and safe in the treatment of PGTCS. Interestingly, this mechanism of action also shows advantages in the treatment of some definite types of focal epilepsy, such as post-stroke epilepsy [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Eslicarbazepine Acetate as Adjunctive Therapy for Primary Generalized Tonic-Clonic Seizures in Adults: A Prospective Observational Study

et al. 2022

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Background Eslicarbazepine acetate (ESL), a novel sodium channel blocker, is approved for mono and adjunctive treatment of partial epileptic seizures with or without secondary generalization. Its efficacy in primary generalized seizures has not yet been evaluated. Objective To evaluate the efficacy and safety of ESL in primary generalized tonic-clonic seizures (PGTCS) in an observational study. Methods The data were collected from a prospective population-based register. Effectiveness was measured as relative reduction in standardized seizure frequency (SSF), responder rate (≥ 50% reduction in SSF), and seizure freedom rate at 6 and 12 months after initiation of ESL. Safety and tolerability were evaluated using patients’ diaries. Results Fifty-six adult patients with PGTCS were treated with ESL as adjunctive therapy. Of these, 30.4% ( n = 17) had myoclonic seizures in addition to PGTCS. The retention rate after 12 months was 80.4% ( n = 45). After initiating ESL therapy, reduction in SSF for PGTCS on ESL was 56.0% after 6 months and 56.9% after 12 months ( p < 0.01), whereas myoclonic seizures did not show any significant improvement in frequency. The responder rate for PGTCS was 64.3% after 6 months and 66.1% after 12 months, and seizure freedom was achieved in 32.1% and 35.7%, respectively. Forty-three patients (73.2%) reported no side effects. Among the reported side effects of ESL therapy, headache (7.1%), dizziness (8.9%), tiredness (7.1%), nausea (5.4%), and hyponatremia (5.4%) were the most prevalent. Conclusions Our data suggest that ESL may provide additional benefits in the treatment of patients with PGTCS and motivate randomized controlled trials in this indication.

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Efficacy and safety of antiseizure medication in post-stroke epilepsy

Cited by 11 publications

References 29 publications

Eslicarbazepine acetate for the treatment of status epilepticus

Eslicarbazepine acetate for the treatment of status epilepticus

Comparative Study on the Effect and Influence of Sodium Valproate and Perampanel on Nerve Damage and Cognitive Function in Epilepsy

Eslicarbazepine Acetate as Adjunctive Therapy for Primary Generalized Tonic-Clonic Seizures in Adults: A Prospective Observational Study

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