Early seizures in intracerebral hemorrhage
Incidence, associated factors, and outcome
Abstract
Objective:
In patients with spontaneous intracerebral hemorrhage (ICH), the occurrence of early seizures (ES) may be a prognostic marker. Therefore, we aimed to identify incidence, associated factors, and influence on outcome of ES in patients with ICH.
Methods:
Between November 2004 and March 2009, we prospectively recruited 562 consecutive adults with a spontaneous ICH (Prognosis of InTra-Cerebral Hemorrhage cohort). Patients with previous seizures (n = 40) were excluded. ES were defined as seizures occurring within 7 days of stroke onset, and their associated factors were identified with Cox regression. For a subgroup of onset seizures, we used logistic regression. Data influencing outcome (mortality at day 7 and month 6 and functional outcome at month 6) were studied using survival analyses.
Results:
ES occurred in 71 (14%; 95% confidence interval [CI] 11–17) of 522 patients (274 male; median age 72 years, interquartile range 58–79 years). The only factor associated with ES was cortical involvement of ICH (odds ratio [OR] = 2.06; 95% CI 1.28–3.31). Regarding onset seizures (n = 38) (7%; 95% CI 5–10), associated factors were previous ICH (OR = 4.76; 95% CI 1.53–14.84), cortical involvement (OR = 2.21; 95% CI 1.11–4.43), younger age (OR = 0.97 per 1 year increase; 95% CI 0.95–0.99), and severity of the neurologic deficit at admission (OR = 1.03 per 1 point increase in the National Institutes of Health Stroke Scale score; 95% CI 1.01–1.06). ES did not influence vital or functional outcome.
Conclusions:
ES are a frequent complication in patients with spontaneous ICH; however, their occurrence does not influence outcome at 6 months.
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Copyright © 2011 by AAN Enterprises, Inc.
Publication History
Received: December 28, 2010
Accepted: April 20, 2011
Published online: October 5, 2011
Published in print: November 15, 2011
Disclosure
Dr. De Herdt has served on a scientific advisory board for UCB and received funding for travel from Janssen. Dr. Dumont reports no disclosures, Dr. Hénon has received research support from sanofi-aventis, Servier, EBEWE Pharma, CoLucid Pharmaceuticals, PhotoThera, and BrainsGate. Dr. Derambure has served on scientific advisory boards for GlaxoSmithKline and Eisai Inc.; has received funding for travel from Eisai Inc.; has received speaker honoraria from Eisai Inc. and UCB; serves on the editorial board of Clinical Neurophysiology; and has received research support from GlaxoSmithKline and UCB. Dr. Vonck has received speaker honoraria from Cyberonics, Inc., UCB, and Pfizer, Inc. Dr. Leys has had consultancy roles and has contributed to advisory boards, steering committees, and adjudication committees for sanofi-aventis, Servier, Boehringer Ingelheim, AstraZeneca, Allergan, Inc., EBEWE Pharma, and Novo Nordisk, fees for which were paid toward research at ADRINORD (Association pour le Développement de la Recherche et de l'Innovation dans le Nord-Pas de Calais) or the research account of the hospital (délégation à la recherche du CHU de Lille); and was reimbursed for travel or accommodation expenses needed for the participation on these boards and committees. Dr. Cordonnier has received research support from sanofi-aventis, PhotoThera, and BrainsGate.
Authors
Author Contributions
Dr. De Herdt analyzed and interpreted all data, contributed to study design, performed statistical analysis, and drafted the manuscript. Dr. Dumont collected the study data. Dr. Hénon conceptualized and designed the study, interpreted and collected study data, and revised the manuscript. Dr. Derambure contributed to data collection and revised the manuscript. Dr. Vonck revised the manuscript. Dr. Leys conceptualized the study, collected study data, and revised the manuscript, Dr. Cordonnier collected study data, designed and conceptualized the study, analyzed and interpreted all data, performed statistical analysis, and drafted the manuscript.
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