OBJECTIVES

: To describe incidence of epilepsy after stroke diagnosis and antiepileptic drug treatment of patients with post-stroke epilepsy claims in Germany.

METHODS

: The analysis was based on a German statutory claims data set (2010-2016, Saxony/Thuringia). The study population consisted of all patients with a hospitalization due to acute stroke (ICD-10 I60/I61/I62/I63/I64.-) from 01/01/2011 to 31/12/2015. Patient observation started at date of first observed hospitalization with acute stroke and lasted until end of data availability (31/12/2016) or until death of patients. Incidence of stroke and epilepsy (defined as at least one ICD-10 G40.- during the observation period during/after index hospitalization claim after stroke) and antiepileptic drug (AED) treatment was analyzed.

RESULTS

: We observed 53,883 stroke patients (2011-2015), yearly incidence: 3.82-3.87 event per 1,000 person-years; mean age 76.2 years, 55.8% female. Of all strokes, 14.7% were hemorrhagic, 81.4% ischemic, and 3.9% unspecified. 6,054 (11.2%) of these patients had ≥1 epilepsy claim over a median follow up period of 884 days (mean 932.7 days; mean age 74.0 years, 54.2% female). Mean time from acute stroke to first epilepsy claim was 272.2 days (median 109 days, standard deviation 385.1 days). 35.2% of patients had an epilepsy claim during the index hospitalization, 39.4% within one year, and 25.4% after one year after index hospitalization. After excluding epilepsy codes recorded during index hospitalization, 43.1% received the diagnosis from general practitioners or neurologists, and 56.9% in a hospital. After epilepsy claim 75.2% of patients received AED treatment; most frequent treatments were Levetiracetam (50.0%), Valproic acid (13.8%), Lorazepam (10.9%), Gabapentin (7.4%), and Lamotrigine (7.1%).

CONCLUSIONS

: A substantial proportion of patients with stroke (11.2%) had ≥1 epilepsy claim during/after hospitalization for stroke. Reasons why a quarter of patients did not receive any AED treatment after epilepsy claim require further research.