E Olafsson1, G Gudmundsson, W A Hauser. 1. Department of Neurology, National University Hospital Landspitalinn, Reykjavik, Iceland. eliasol@rsp.is
Abstract
PURPOSE: Epilepsy is known to result from aneurysmal subarachnoid hemorrhage (SAH). There are no population-based estimates of the absolute risk or the duration for which this risk is elevated. We have conducted a population-based study in Iceland of the risk of epilepsy after a ruptured cerebral aneurysm to address these questions. METHODS: The index patients are all of the patients who presented with SAH caused by ruptured cerebral aneurysm in Iceland during an 11-year period (1958 to 1968) and survived more than 6 months. We determined the number of index patients who developed epilepsy. The observed number of cases of epilepsy was compared with that expected based on the incidence of epilepsy in Iceland. RESULTS: There were 44 index patients; 11 (25%) developed epilepsy, all within 4 years of the insult. Seven (70%) of 10 patients with acute symptomatic seizures (defined as seizures during the first 2 weeks after the hemorrhage) developed epilepsy (relative risk, 7.0; 95% confidence interval, 2.3-21.6). Epilepsy was more frequent in patients with severe neurological residua (48%) compared with patients without (20%) (relative risk, 2.5; 95% confidence interval, 0.9-6.3). CONCLUSIONS: The risk for epilepsy among survivors of SAH caused by ruptured cerebral aneurysm is substantially increased. Both acute symptomatic seizure and persistent neurological impairment are associated with a further increase in the risk of epilepsy.
PURPOSE:Epilepsy is known to result from aneurysmal subarachnoid hemorrhage (SAH). There are no population-based estimates of the absolute risk or the duration for which this risk is elevated. We have conducted a population-based study in Iceland of the risk of epilepsy after a ruptured cerebral aneurysm to address these questions. METHODS: The index patients are all of the patients who presented with SAH caused by ruptured cerebral aneurysm in Iceland during an 11-year period (1958 to 1968) and survived more than 6 months. We determined the number of index patients who developed epilepsy. The observed number of cases of epilepsy was compared with that expected based on the incidence of epilepsy in Iceland. RESULTS: There were 44 index patients; 11 (25%) developed epilepsy, all within 4 years of the insult. Seven (70%) of 10 patients with acute symptomatic seizures (defined as seizures during the first 2 weeks after the hemorrhage) developed epilepsy (relative risk, 7.0; 95% confidence interval, 2.3-21.6). Epilepsy was more frequent in patients with severe neurological residua (48%) compared with patients without (20%) (relative risk, 2.5; 95% confidence interval, 0.9-6.3). CONCLUSIONS: The risk for epilepsy among survivors of SAH caused by ruptured cerebral aneurysm is substantially increased. Both acute symptomatic seizure and persistent neurological impairment are associated with a further increase in the risk of epilepsy.
Authors: Baxter B Allen; Peter B Forgacs; Malik A Fakhar; Xian Wu; Linda M Gerber; Srikanth Boddu; Santosh B Murthy; Philip E Stieg; Halinder S Mangat Journal: Neurocrit Care Date: 2018-08 Impact factor: 3.210
Authors: Alexander E Merkler; Gino Gialdini; Michael P Lerario; Neal S Parikh; Nicholas A Morris; Benjamin Kummer; Lauren Dunn; Michael E Reznik; Santosh B Murthy; Babak B Navi; Zachary M Grinspan; Costantino Iadecola; Hooman Kamel Journal: Stroke Date: 2018-04-25 Impact factor: 7.914
Authors: Eric Peter Thelin; Tamara Tajsic; Frederick Adam Zeiler; David K Menon; Peter J A Hutchinson; Keri L H Carpenter; Maria Cristina Morganti-Kossmann; Adel Helmy Journal: Front Neurol Date: 2017-07-20 Impact factor: 4.003