Double-dose statin treatment may reduce incidence of post-stroke epilepsy

Several in vivo and in vitro studies indicate that statins might reduce the risk of developing epilepsy. However, the effect of different dose of statins on the incidence of post-stroke epilepsy remains unclear. Therefore, researchers of the Hospital of Harbin Medical University, China conducted a study to explore whether a double-dose statin treatment can better prevent the occurrence of PSE.

It was a hospital-based cohort study of 1152 patients with newly diagnosed ischemic stroke between March to August 2017. Among 1152 patients, 1033 were followed up. The researchers assigned them to receive either standard-dose (20 mg atorvastatin or 10 mg rosuvastatin, daily oral; 788 patients) or double-dose (40 mg atorvastatin or 20 mg rosuvastatin, daily oral; 245 patients). They conducted a follow-up after 18 months to compare the incidence of PSE between groups.

Key findings of the study were:

• In the standard-dose group, the researchers observed two cases of early seizure (ES) (0.25%), 22 cases of late seizure (LS) (2.79%) and 20 cases of PSE (2.54%). In the double-dose group, they observed that one patient had ES (0.41%), two patients had LS (0.82%), and one patient had PSE (0.41%).
• They found that the incidence of PSE was significantly lower in the double-dose group as compared to the standard-dose group.
• They also found a higher proportion of PSE in patients younger than 65 years and males.
• They reported that 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, they noted two cases of FAS, five cases of focal impaired awareness seizure (FIAS), five cases of FBTCS, and nine cases of GTCS, which implies that partial seizure is the most common type of PSE.
• They also noted that the cerebral cortex was involved in 85.75% of cases with PSE, and multiple lobes were involved in 61.9% of cases with PSE.

The authors concluded, " 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 post-stroke epilepsy (PSE) ."

For further information:

https://www.seizure-journal.com/article/S1059-1311(21)00126-6/fulltext