Effects of double-dose statin therapy for the prevention of post-stroke epilepsy: A prospective clinical study

 Does your doctor already have a protocol to prevent post stroke epilepsy and seizures? 

Your risk of post-stroke seizure is highest in the first 30 days following a stroke. Approximately 5 percent of people will have a seizure within a few weeks after having a stroke, according to the National Stroke Association.

Effects of double-dose statin therapy for the prevention of post-stroke epilepsy: A prospective clinical study

• Yanmei Zhu ^#
• Haiyan Gou ^#
• Long Ma ^#
• 
  
• Jia He
• Yan Chen
• Yulan Zhu
• Show all authors
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Published:April 14, 2021DOI:https://doi.org/10.1016/j.seizure.2021.04.010

Highlights

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  Double-dose statin treatment reduces the incidence of post-stroke epilepsy (PSE) during the acute phase of ischemic stroke, which is better than a standard-dose.
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  PSE incidence was higher in patients under 65 years of age, and more males than females were affected.
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  The majority of PSE occurred between 6 and 12 months after the beginning of statin treatment.

ABSTRACT

Background

: To determine treatment effects on the incidence of post-stroke epilepsy (PSE) using different doses of statin, a prospective hospital-based cohort study was designed to explore whether a double-dose statin treatment can better prevent the occurrence of PSE.

Methods

:A total of 1152 patients with newly diagnosed ischemic stroke admitted to our hospital from March to August 2017 were selected, 1033 of whom were followed-up. Patients were divided into two treatment groups:(1) standard-dose (20 mg atorvastatin or 10 mg rosuvastatin,daily oral; 788 patients); and (2) double-dose (40 mg atorvastatin or 20 mg rosuvastatin, daily oral; 245 patients).At 18 months follow-up was conducted to compare the incidence of PSE between groups.

Results

: In general, in the standard-dose group we observed two cases of early seizure (ES) (0.25%), 22 cases oflate seizure (LS) (2.79%) and 20 cases of PSE (2.54%). In the double-dose group, onepatient had ES (0.41%), two patients had LS (0.82%), and onepatient had PSE (0.41%). The incidence of PSE was significantly lower in the double-dose group as compared to the standard-dose group. There was a higher proportion of PSE in patients younger than 65 years and in males. Three patients had ES; one presented with focal aware seizure (FAS), and two had focal to bilateral tonic-clonic seizure (FBTCS). Among the 21 patients with PSE, there were two cases of FAS, five cases of focal impaired awareness seizure (FIAS), five cases of FBTCS, and nine cases of GTCS, suggesting that partial seizure is the most common type of PSE. Cerebral cortex was involved in 85.75% of cases with PSE, and multiple lobes were involved in 61.9% of cases with PSE.

Conclusion

: Increasing the dose of statin treatment during the acute phase of ischemic stroke reduces the incidence of PSE. Further research is needed to understand the mechanisms underlying the potential preventative effects of statins against PSE.