Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy
Objectives: The study aimed to explore the clinical predictors of pharmaco-resistance in patients with post-stroke epilepsy (PSE). Methods: Patients with epilepsy secondary to cerebral infarct or spontaneous intracerebral hemorrhage were included. The study outcome was the occurrence of pharmaco-res...
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| Format: | Article |
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MDPI AG
2021-03-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/4/418 |
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| author | Simona Lattanzi Claudia Rinaldi Claudia Cagnetti Nicoletta Foschi Davide Norata Serena Broggi Chiara Rocchi Mauro Silvestrini |
| author_facet | Simona Lattanzi Claudia Rinaldi Claudia Cagnetti Nicoletta Foschi Davide Norata Serena Broggi Chiara Rocchi Mauro Silvestrini |
| author_sort | Simona Lattanzi |
| collection | DOAJ |
| description | Objectives: The study aimed to explore the clinical predictors of pharmaco-resistance in patients with post-stroke epilepsy (PSE). Methods: Patients with epilepsy secondary to cerebral infarct or spontaneous intracerebral hemorrhage were included. The study outcome was the occurrence of pharmaco-resistance defined as the failure of adequate trials of two tolerated and appropriately chosen and used antiseizure medication schedules, whether as monotherapies or in combination, to achieve sustained seizure freedom. Results: One-hundred and fifty-nine patients with PSE and a median follow-up of 5 (3–9) years were included. The mean age of the patients at stroke onset was 56.7 (14.9) years, and 104 (65.4%) were males. In the study cohort, 29 participants were pharmaco-resistant. Age at stroke onset [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.93–0.99; <i>p</i> = 0.044], history of intracerebral hemorrhage (OR 2.95, 95% CI 1.06–8.24; <i>p</i> = 0.039), severe stroke (OR 5.43, 95% CI 1.82–16.16; <i>p</i> = 0.002), status epilepticus as initial presentation of PSE (OR 7.90, 1.66–37.55; <i>p</i> = 0.009), and focal to bilateral tonic-clonic seizures (OR 3.19, 95% CI 1.16–8.79; <i>p</i> = 0.025) were independent predictors of treatment refractoriness. Conclusions: Pharmaco-resistance developed in approximately 20% of patients with PSE and was associated with younger age at stroke onset, stroke type and severity, status epilepticus occurrence, and seizure types. |
| first_indexed | 2024-03-10T12:53:38Z |
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| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T12:53:38Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-ce7efaa794c24ba6a295e493e52622952023-11-21T12:07:44ZengMDPI AGBrain Sciences2076-34252021-03-0111441810.3390/brainsci11040418Predictors of Pharmaco-Resistance in Patients with Post-Stroke EpilepsySimona Lattanzi0Claudia Rinaldi1Claudia Cagnetti2Nicoletta Foschi3Davide Norata4Serena Broggi5Chiara Rocchi6Mauro Silvestrini7Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60020 Ancona, ItalyObjectives: The study aimed to explore the clinical predictors of pharmaco-resistance in patients with post-stroke epilepsy (PSE). Methods: Patients with epilepsy secondary to cerebral infarct or spontaneous intracerebral hemorrhage were included. The study outcome was the occurrence of pharmaco-resistance defined as the failure of adequate trials of two tolerated and appropriately chosen and used antiseizure medication schedules, whether as monotherapies or in combination, to achieve sustained seizure freedom. Results: One-hundred and fifty-nine patients with PSE and a median follow-up of 5 (3–9) years were included. The mean age of the patients at stroke onset was 56.7 (14.9) years, and 104 (65.4%) were males. In the study cohort, 29 participants were pharmaco-resistant. Age at stroke onset [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.93–0.99; <i>p</i> = 0.044], history of intracerebral hemorrhage (OR 2.95, 95% CI 1.06–8.24; <i>p</i> = 0.039), severe stroke (OR 5.43, 95% CI 1.82–16.16; <i>p</i> = 0.002), status epilepticus as initial presentation of PSE (OR 7.90, 1.66–37.55; <i>p</i> = 0.009), and focal to bilateral tonic-clonic seizures (OR 3.19, 95% CI 1.16–8.79; <i>p</i> = 0.025) were independent predictors of treatment refractoriness. Conclusions: Pharmaco-resistance developed in approximately 20% of patients with PSE and was associated with younger age at stroke onset, stroke type and severity, status epilepticus occurrence, and seizure types.https://www.mdpi.com/2076-3425/11/4/418brain infarctcerebral hemorrhagestroke |
| spellingShingle | Simona Lattanzi Claudia Rinaldi Claudia Cagnetti Nicoletta Foschi Davide Norata Serena Broggi Chiara Rocchi Mauro Silvestrini Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy Brain Sciences brain infarct cerebral hemorrhage stroke |
| title | Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy |
| title_full | Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy |
| title_fullStr | Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy |
| title_full_unstemmed | Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy |
| title_short | Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy |
| title_sort | predictors of pharmaco resistance in patients with post stroke epilepsy |
| topic | brain infarct cerebral hemorrhage stroke |
| url | https://www.mdpi.com/2076-3425/11/4/418 |
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