Early seizures in intracerebral hemorrhage

Abstract

ES are a frequent complication in patients with spontaneous ICH; however, their occurrence does not influence outcome at 6 months.

The CAVE Score for Predicting Late Seizures After Intracerebral Hemorrhage

“…Convulsive seizures may become less frequent, and clinical seizure manifestations may be more difficult to recognize in the elderly. 25 Several previous studies, 3,4,19,20,24,26 in line with our results, reported that cortical and lobar ICH represent highly epileptogenic lesions. Electrophysiological studies showed greater probability of spontaneous synaptic events and increased excitability in response to synaptic stimulation in neurons adjacent to cortical lesion compared with those surrounding glia.…”

“…Cumulative risk of LS was 7.1% at 1 year after ICH and 11.8% at 5 years. This is in line with earlier reports [3][4][5]19,20 although comparisons between studies are difficult because of different patient populations, seizure criteria, and follow-up…”

“…Recently presented data on patient populations similar to ours also demonstrated an association of younger age with seizures. 3,23,24 This association might reflect the higher survival of younger ICH patients. Differences in the clinical manifestation of epilepsy in elderly and younger adults can lead to underestimation of epilepsy incidence in older people.…”

“…In the recent prospective studies, symptomatic seizures among patients with ICH have ranged from 5% to 14% within the first days after event. [1][2][3] During 2 years of follow-up, 8% to 10% of ICH survivors develop additional late seizures (LS). 4,5 Early seizures are thought to result from structural changes producing acute disruption of brain integrity, metabolic homeostasis, and transient depolarizations, whereas LS relate to neuronal reorganization and formation of epileptogenic foci.…”

Epilepsy in elderly patients

“…Literatüre göre inme sonrası akut semptomlu nöbetler ilk birinci haftada ortaya çıkar ve bu durum daha çok intraserebral hemorajilerde (%14) görülmektedir. [4] Geç nöbet insidansı ise %3-14 olup en sık üçüncü ay ya da birinci yılda epilepsi meydana gelmektedir. [5,6] Bu çalışmada akut semptomatik nöbet geçiren hastalar dahil edilmemiştir.…”