Abstracts

Rationale: There is a notion that statin medications might represent a novel approach to epilepsy treatment. Data generated in animal studies suggest antiepileptic and antiepileptogenic properties of statins. There is also data from human studies noting decreased risk of developing epilepsy in patients on a statin. Our goal was to explore the effect of statins on seizure frequency in patients with established epilepsy. Methods: We performed a retrospective chart review and generated a case series of patients with a well-established diagnosis of epilepsy, ages 18-80, who were prescribed a statin medication. All patients experienced at least one seizure over a 6-month period prior to statin introduction. We collected demographics, epilepsy etiology, and diagnostic data. We compared average seizure frequency per 28 day-period over the 6 months prior to statin initiation to seizure frequency over 12 months after statin use. We excluded patients with non-epileptic seizures, pregnancy, use of immunomodulatory agents, and significant changes of antiepileptic medications during the observed period. Institutional Review Board approval was obtained prior to the start of this study. Results: We reviewed 234 charts and 8 patients fulfilled our criteria. Three patients were women. Five patients had symptomatic epilepsy with focal onset seizures, and three had idiopathic generalized epilepsy (IGE). The age at epilepsy diagnosis was 1-24 years (median: 5 years, mean: 8 years). Duration of epilepsy prior to statin initiation was 13-59 years (median: 43 years, mean: 40.25 years). All patients continued to have seizures with at least two antiepileptic medication trials at the time of statin initiation. Four of eight patients had decreased seizure frequency, two had no change, and two had increased seizure frequency after initiation of statins. In patients with decrease in seizure frequency, the age of epilepsy diagnosis was 1-16 years, and duration of epilepsy prior to statins was 35-52 years. There were two patients with IGE and two patients with symptomatic epilepsy. These patients were previously on 1-5 antiepileptic medications, and 1-3 medications were used during the observed period. Statins prescribed included Atorvastatin 20-40 mg and Simvastatin 10-20 mg. In patients observed to have no change or increase in seizure frequency, age at time of epilepsy diagnosis was 3-24 years and epilepsy duration prior to use was 13-59 years. One patient had IGE and three patients had symptomatic epilepsy. Previous antiepileptic regimens included 0-4 medications, and 1-3 medications were used during the observed period. Statins prescribed included Atorvastatin 10 mg and Simvastatin 20 mg. Conclusions: Fifty percent of patients (4 out of 8) with medically refractory epilepsy had decreased seizure frequency upon statin initiation. We acknowledge several limitations, including a small group of patients, no matched control group, and the retrospective data collection; however, our results support a potential role of statins in treatment of epilepsy. Funding: None