Efficacy and safety of Oxcarbazepine versus Phenytoin in controlling post stroke seizures in the elderly

The prevalence of epilepsy in the elderly is more than other age groups and treatment of epilepsy in this group is challenging for neurologists. The purpose of this study is to compare the efficacy and safety of phenytoin versus oxcarbazepine in the elderly patients with newly diagnosed secondary generalized seizure.

We enrolled 142 elderly patients with epilepsy after considering the measures of exclusion and inclusion criteria. The patients were divided in two groups (A&B) randomly. For the group A phenytoin capsule (>70 y/o 100mg BID & <70 y/o 100mg TDS) and the group B oxcarbazepine 300mg BID tablet were administered in a double blind manner. Through this study all patient were followed up for side effects and their response to treatment (not having seizure) for 6 months.

In group A 91.5% of the patients (n=54) were seizure free in the period of 6 months and in the group B 86.6% of the patients (n=58) were seizure free (p=0.377). The frequency of adverse effects was 18.2% in the group A (n=12) and in the group B 6.5% (n=4) of the patients had adverse effects (p=0.045).

Both oxcarbazepine and phenytoin are effective in controlling post stroke seizures but adverse effects of oxcarbazepine are less. Therefore oxcarbazepine seems to be a suitable alternative choice for treatment of Seizure in this age group and can be used as first line monotherapy in the elderly patient with Seizure.