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Predictors of unprovoked seizures in intracerebral hemorrhages

Jing Qiang1, Yanyan Wang1, Qiongqiong Zhai1

  • 1Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.

Acta Neurologica Belgica
|March 5, 2023
PubMed

Insights

Predictors of unprovoked seizures after intracerebral hemorrhage (ICH) were identified. Craniotomy and acute symptomatic seizures (ASS) independently predict unprovoked seizures, highlighting the need for vigilant follow-up in affected patients.

Area of Science:

  • Neurology
  • Neurosurgery
  • Epidemiology

Background:

  • Seizures are a frequent complication following intracerebral hemorrhage (ICH).
  • Identifying predictors of unprovoked seizures (US) post-ICH is crucial for patient management.
  • This study focuses on a Chinese cohort to determine these predictors.

Purpose of the Study:

  • To identify independent predictors of unprovoked seizures (US) after intracerebral hemorrhage (ICH).
  • To evaluate the impact of prophylactic anti-seizure medications (ASM) on US incidence in patients undergoing craniotomy.

Main Methods:

  • Retrospective cohort study including 488 ICH patients.
  • Univariate and multiple Cox regression analyses were used to identify risk factors for US.
  • Chi-squared test compared US incidence between groups with and without prophylactic ASM in craniotomy patients.

Main Results:

  • 11.9% of patients developed US within 3 years post-ICH.
  • Craniotomy (HR 8.35) and acute symptomatic seizures (ASS) (HR 13.76) were independent predictors of US.
  • Prophylactic ASM did not significantly affect US incidence in craniotomy patients (P=0.369).

Conclusions:

  • Craniotomy and ASS are significant independent predictors for developing unprovoked seizures after ICH.
  • Patients with ICH, particularly those undergoing craniotomy or experiencing ASS, require closer follow-up.
  • The benefit of prophylactic ASM in ICH patients who undergo craniotomy remains uncertain.
Abstract

Keywords:
Acute symptomatic seizuresAnti-seizure medicationsCraniotomyIntracerebral hemorrhageUnprovoked seizures

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