Seizures at the onset of subarachnoid haemorrhage.

In a prospective study of 253 patients with subarachnoid haemorrhage, 16 (6.3%) had seizures at the onset of bleeding. None had a previous history of seizures. One was an alcoholic. None had metabolic imbalance. Hemiparesis, Hunt's grade > 3, the amount of subarachnoid blood and the presence of an aneurysm were significantly more frequent in patients with seizures at the onset of subarachnoid haemorrhage. Although rebleeding and mortality or severe disability at discharge were more frequent in these patients, seizures were not a significant predictor of prognosis. One of the survivors with early seizures developed recurrent epileptic seizures 1 year later.