Soichiro Matsubara1,2, Shoichiro Sato2, Tomohiro Kodama3, Satoshi Egawa3, Hidetoshi Nakamoto3, Kazunori Toyoda2, Yuichi Kubota3. 1. From the Stroke and Epilepsy Center, TMG Asaka Medical Center, Asaka, Saitama, Japan (S.M., T.K., S.E., H.N., Y.K.) matsubara-soichiro@umin.ac.jp. 2. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan (S.M., S.S., K.T). 3. From the Stroke and Epilepsy Center, TMG Asaka Medical Center, Asaka, Saitama, Japan (S.M., T.K., S.E., H.N., Y.K.).
Abstract
BACKGROUND AND PURPOSE: Patients with acute intracerebral hemorrhages (ICHs) often develop nonconvulsive status epilepticus (NCSE). We aimed to identify determinants and the prognostic significance of NCSE among patients with acute ICH. METHODS: Consecutive patients with acute spontaneous ICH who were admitted to a comprehensive stroke center were enrolled. We diagnosed NCSE using the modified Salzburg Consensus Criteria. Factors associated with NCSE and their significance in relation to clinical outcomes were assessed using multivariate logistic regression models. RESULTS: Of 228 patients (136 men; mean age, 68±14 years), 20 (8.8%) developed NCSE during their hospital stays. In logistic regression models, the adjusted odds ratios (95% confidence intervals) for NCSE were 3.5 (1.2-10.7) for craniotomy and 7.0 (2.2-31.2) for lobar involvement. The patients with NCSE had higher modified Rankin Scale scores at discharge, but NCSE was not independently associated with poor functional outcomes (modified Rankin Scale score, 4-5) or mortality after adjusting for confounders. CONCLUSIONS: NCSE is not a rare complication of acute ICH. Craniotomy and lobar involvement are independently associated with NCSE in patients with acute ICH.
BACKGROUND AND PURPOSE:Patients with acute intracerebral hemorrhages (ICHs) often develop nonconvulsive status epilepticus (NCSE). We aimed to identify determinants and the prognostic significance of NCSE among patients with acute ICH. METHODS: Consecutive patients with acute spontaneous ICH who were admitted to a comprehensive stroke center were enrolled. We diagnosed NCSE using the modified Salzburg Consensus Criteria. Factors associated with NCSE and their significance in relation to clinical outcomes were assessed using multivariate logistic regression models. RESULTS: Of 228 patients (136 men; mean age, 68±14 years), 20 (8.8%) developed NCSE during their hospital stays. In logistic regression models, the adjusted odds ratios (95% confidence intervals) for NCSE were 3.5 (1.2-10.7) for craniotomy and 7.0 (2.2-31.2) for lobar involvement. The patients with NCSE had higher modified Rankin Scale scores at discharge, but NCSE was not independently associated with poor functional outcomes (modified Rankin Scale score, 4-5) or mortality after adjusting for confounders. CONCLUSIONS: NCSE is not a rare complication of acute ICH. Craniotomy and lobar involvement are independently associated with NCSE in patients with acute ICH.
Authors: Zhe Kang Law; Timothy J England; Amit K Mistri; Lisa J Woodhouse; Lesley Cala; Rob Dineen; Serefnur Ozturk; Maia Beridze; Ronan Collins; Philip M Bath; Nikola Sprigg Journal: Eur Stroke J Date: 2020-01-24