Predictors and outcome of seizures after spontaneous intracerebral hemorrhage

Clinical article

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  • 1 Departments of Neurosurgery,
  • 2 Radiology, and
  • 3 Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Object

Seizures are an important neurological complication of spontaneous intracerebral hemorrhage (ICH). A better understanding of the risk factors of seizures following ICH is needed to predict which patients will require treatment.

Methods

Two hundred and forty-three adult patients were enrolled in this 1-year retrospective study. Multiple logistic regression was used to evaluate the relationship between baseline clinical factors and the presence or absence of seizure during the study period.

Results

Seizures occurred in 20 patients with ICH, including acute symptomatic seizures in 9 and unprovoked seizures in 11. None progressed to status epilepticus during hospitalization. After a minimum 3-year follow-up period, the mean Glasgow Outcome Scale score was 3.8 ± 1.1 for patients who had had seizures and 3.5 ± 1.3 for those who had not. The multiple logistic regression model demonstrated that the mean ICH volume was independently associated with seizures, and any increase of 1 mm3 in ICH volume increased the seizure rate by 2.7%.

Conclusions

Higher mean ICH volumes at presentation were predictive of seizure, and the presence of late seizures was predictive of developing epilepsy. Most seizures occurred within 2 years of spontaneous ICH over a minimum of 3 years of follow-up.

Abbreviations used in this paper: AED = antiepileptic drug; GCS = Glasgow Coma Scale; GOS = Glasgow Outcome Scale; ICH = intracerebral hemorrhage; ROI = region of interest.

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Contributor Notes

Address correspondence to: Cheng-Hsien Lu, M.D., Department of Neurology, Chang Gung, Memorial Hospital 123, Ta Pei Road, Niao Sung Hsiang Kaohsiung Hsien, Taiwan. email: chlu99@ms44.url.com.tw.
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