Correlation Between Liver Function and Risk of Post-Stroke Epilepsy.

BACKGROUND

Abnormal liver function has often been associated with epilepsy, but there is a lack of large-scale clinical evidence to support the potential correlation between liver function and post-stroke epilepsy.

OBJECTIVE

We aimed to explore a real correlation between liver function and secondary epilepsy after stroke.

METHODS

From the Dryad database, we retrospectively identified 21,459 patients who had experienced acute ischemic stroke. Multivariate regression was used to clarify the correlation between liver function and secondary epilepsy post-stroke via cross-sectional analysis.

RESULTS

Our multivariate nonlinear analysis, adjusted for age and gender, suggested that a significant correlation exists between liver function (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and the risk of secondary epilepsy post-stroke. Saturation effect analysis showed that a fold point (K) of blood AST level of 39.3 U/L was related to an epilepsy event. An increased AST level was related to a higher rate of epilepsy (1.2 [1.2-1.3], <0.001) among patients with AST levels of less than 39.3 U/L. Significance was weaker among patients with AST levels of more than 39.3 U/L. As for ALT, the fold point of blood ALT level revealed an association with epilepsy at 23.3 U/L. Similarly, elevated AST levels were related to a significantly higher risk of secondary epilepsy post-stroke (1.2 [1.1-1.2], <0.001) when they were less than 23.3 U/L. The significant correlation was weaker when blood AST levels were higher than 23.3 U/L. Importantly, ROC curve analysis displayed a high AUC value (0.8101) of blood AST in terms of detecting epilepsy risk, with a sensitivity of 0.7254 and specificity of 0.7997, respectively.

CONCLUSION

Our study provided potential evidence for the correlation between liver function and secondary epilepsy after acute stroke, indicating that early protection and management of liver dysfunction among post-stroke patients might be beneficial for reducing epileptic seizures. More studies with a high level of evidence are needed to confirm this finding, however.