COMPARISON OF FUNCTIONAL OUTCOMES AND AED DRUGS USED IN ISCHEMIC STROKE PATIENTS WITH AND WITHOUT SEIZURES.

Abstract

Introduction: stroke is common neurological disorder all over the world. Objective: To compare the functional outcome of acute ischemic stroke patients presenting with and without seizures and to evaluate the preferred antiepileptic drug used in those patients. Methods: This was a cohort study conducted at the department of emergency and neurology of Liaquat University of medical and health sciences hospital, Hyderabad and Jamshoro from September 2017 to December 2019. Two hundred patients of age 16-80 years of either gender presenting with acute ischemic stroke were included using non-random consecutive sampling method. Patients were investigated for information consisting of demographic details, comorbids, imaging reports and stroke etiology. EEG was done to classify the seizure types and the severity of stroke was measured by NIHSS (National institutes of health stroke scale) score. Patients were then treated with antiepileptic drug according to co-morbid conditions. Stroke functional outcome was measured by modified Rankin scale on discharge while seizure control was monitored by recurrence of clinical and subclinical seizures. Statistical software SPSS version 23 was used to analyze data. Results: The mean age of the patients was estimated as 56.98±8.78 years.Statistically significant association was found between functional outcomes and NIHSS score, stroke etiology and seizures (p≤0.05).Out of 28 patients with treated with levitiracetam, 85.7% experienced recurrence of clinical and subclinical seizures while in 20 patients treated with lacosamide, no recurrence was observed. The statistically significant association was found between AED drug used and recurrence of seizures (p<0.05). Conclusion: In stroke patients stoke severity in terms of higher NIHSS score, stroke etiology and seizures are the independent determinants of poor outcome. Lacosamide was observed best AED drug in terms of prevention of recurrence and better outcome of stroke.