Risk factors and outcome of seizures after spontaneous aneurysmal subarachnoid hemorrhage

• Published in: European journal of neurology Vol. 15; no. 5; pp. 451 - 457
• Main Authors: Lin, Y.-J., Chang, W.-N., Chang, H.-W., Ho, J.-T., Lee, T.-C., Wang, H.-C., Tsai, N.-W., Tsai, M.-H., Lu, C.-H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2008
• Subjects: Adult; Aged; Aged, 80 and over; Cerebral Angiography; Female; Follow-Up Studies; Humans; Male; Middle Aged; outcome; Proportional Hazards Models; Retrospective Studies; Risk Factors; seizure; Seizures - etiology; spontaneous aneurysmal subarachnoid hemorrhage; Subarachnoid Hemorrhage - complications; Subarachnoid Hemorrhage - pathology
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/j.1468-1331.2008.02096.x

Background and purpose:  Seizures are important neurologic complications of spontaneous aneurysmal subarachnoid hemorrhage (SAH). A better understanding of the risk factors of seizures following aneurysmal SAH is needed to predict those who will require treatment. Methods:  A total of 137 adult patients were enrolled in this two‐year retrospective study. Baseline prognostic variables were analyzed based on Cox’s proportional hazards model after a minimum of one‐year follow‐up. Results:  Seizures occurred in 21 patients who had SAH, including acute symptomatic seizures in 11.7% (16/137) and unprovoked seizures in 3.6% (5/137). None progressed to status epilepticus during hospitalization. After a minimum of one‐year follow‐up, the mean Glasgow Outcome Score was 3.5 ± 1.4 for patients with seizures and 3.1 ± 1.1 for those without. Conclusions:  Higher mean World Federation of Neurological Societies grade on presentation was predictive of seizure, but seizure itself was not a significant prognostic predictor after a minimum of one‐year follow‐up. Regarding potential side effects of anti‐epileptic drugs, anti‐epileptic therapy should be carefully administered to patients with seizures after aneurysmal SAH.