Early seizures and risk of epilepsy and death after intracerebral haemorrhage: The MUCH Italy.
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Pezzini Alessandro, Tarantino Barbara, Zedde Marialuisa, Marcheselli Simona, Silvestrelli Giorgio, Ciccone Alfonso, DeLodovici Maria Luisa, Princiotta Cariddi Lucia, Vidale Simone, Paciaroni Maurizio, Azzini Cristiano, Padroni Marina, Gamba Massimo, Magoni Mauro, Del Sette Massimo, Tassi Rossana, De Franco Ivo Giuseppe, Cavallini Anna, Calabrò Rocco Salvatore, Cappellari Manuel, Giorli Elisa, Giacalone Giacomo, Lodigiani Corrado, Zenorini Mara, Valletta Francesco, Cutillo Gianni, Bonelli Guido, Abrignani Giorgia, Castellini Paola, Genovese Antonio, Latte Lilia, Trapasso Maria Claudia, Ferraro Chiara, Piancatelli Francesco, Pascarella Rosario, Grisendi Ilaria, Assenza Federica, Napoli Manuela, Moratti Claudio, Acampa Maurizio, Grassi Mario
Аннотация
PATIENTS AND METHODS: In the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) we examined the risk of ES and whether they predict the occurrence of PSE and all-cause mortality in a cohort of patients with first-ever spontaneous ICH and no previous history of epilepsy, consecutively hospitalized in 12 Italian neurological centers from 2002 to 2014.
RESULTS: Among 2570 patients (mean age, 73.4 ± 12.5 years; males, 55.4%) 228 (8.9%) had acute ES (183 (7.1%) short seizures and 45 (1.8%) status epilepticus (SE)). Lobar location of the hematoma (OR, 1.49; 95% CI, 1.06-2.08) was independently associated with the occurrence of ES. Of the 2,037 patients who were followed-up (median follow-up time, 68.0 months (25th-75th percentile, 77.0)), 155 (7.6%) developed PSE. ES (aHR, 2.34; 95% CI, 1.42-3.85), especially when presenting as short seizures (aHR, 2.35; 95% CI, 1.38-4.00) were associated to PSE occurrence. Unlike short seizures, SE was an independent predictor of all-cause mortality (aHR, 1.50; 95% CI, 1.005-2.26).
DISCUSSION AND CONCLUSION: The long-term risk of PSE and death after an ICH vary according to ES subtype. This might have implications for the design of future clinical trials targeting post-ICH epileptic seizures.