Prevention of seizures after ischemic stroke: association between statin use and the risk of seizures

More than 50 million people worldwide suffer from epilepsy. In approximately 50% cases of newly diagnosed patients over 60 years of age seizures are related to stroke. Post-stroke lesions in brain tissue may result in 7 fold increase risk of seizures compared to the general population. The most significant risk factors for post-stroke seizures (PSS) and post-stroke epilepsy (PSE) include stroke severity, intracerebral or subarachnoid hemorrhage and cortical involvement. Increased incidence of PSS was also observed in younger patients especially with previous early PSS occurrence. Statins (HMG-CoA reductase inhibitors) are a class of lipid-lowering medications characterized by neuroprotective and antiepileptic effects. The main result of the performed studies was significantly reduced risk of developing PSS associated with a post-stroke, but not pre-stroke statin use. Moderate to high doses of statin and early administration in acute phase of stroke potentiated the beneficial effects of the treatment. The evidences for the association between PSS prevention and statin treatment become more significant, however the most recent AHA/ASA recommendations do not include any medications in the PSS prophylaxis. This article summarizes the current knowledge about the prediction and prevention of PSS and PSE.