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01-07-2021 | Stroke | Neurological Update

Seizures and epilepsy after intracerebral hemorrhage: an update

Authors: Laurent Derex, Sylvain Rheims, Laure Peter-Derex

Published in: Journal of Neurology | Issue 7/2021

Abstract

Seizures are common after intracerebral hemorrhage, occurring in 6–15% of the patients, mostly in the first 72 h. Their incidence reaches 30% when subclinical or non-convulsive seizures are diagnosed by continuous electroencephalogram. Several risk factors for seizures have been described including cortical location of intracerebral hemorrhage, presence of intraventricular hemorrhage, total hemorrhage volume, and history of alcohol abuse. Seizures after intracerebral hemorrhage may theoretically be harmful as they can lead to sudden blood pressure fluctuations, increased intracranial pressure, and neuronal injury due to increased metabolic demand. Some recent studies suggest that acute symptomatic seizures (occurring within 7 days of stroke) are associated with worse functional outcome and increased risk of death despite accounting for other known prognostic factors such as age and baseline hemorrhage volume. However, the impact of seizures on prognosis is still debated and it remains unclear if treating or preventing seizures might lead to improved clinical outcome. Thus, the currently available scientific evidence does not support the routine use of antiseizure medication as primary prevention among patients with intracerebral hemorrhage. Only prospective adequately powered randomized-controlled trials will be able to answer whether seizure prophylaxis in the acute or longer term settings is beneficial or not in patients with intracerebral hemorrhage.

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Title: Seizures and epilepsy after intracerebral hemorrhage: an update
Authors: Laurent Derex
Sylvain Rheims
Laure Peter-Derex
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keywords: Stroke
Epilepsy
Levetiracetam
Phenytoin
Published in: Journal of Neurology / Issue 7/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-021-10439-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Seizures and epilepsy after intracerebral hemorrhage: an update

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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