High risk for seizures following subarachnoid hemorrhage regardless of referral bias
BACKGROUND: To investigate the frequency, predictors, and clinical impact of electrographic seizures in patients with high clinical or radiologic grade non-traumatic subarachnoid hemorrhage (SAH), independent of referral bias.
METHODS: We compared rates of electrographic seizures and associated clinical variables and outcomes in patients with high clinical or radiologic grade non-traumatic SAH. Rates of electrographic seizure detection before and after institution of a guideline which made continuous EEG monitoring routine in this population were compared.
RESULTS: Electrographic seizures occurred in 17.6 % of patients monitored expressly because of clinically suspected subclinical seizures. In unselected patients, seizures still occurred in 9.6 % of all cases, and in 8.6 % of cases in which there was no a priori suspicion of seizures. The first seizure detected occurred 5.4 (IQR 2.9-7.3) days after onset of subarachnoid hemorrhage with three of eight patients (37.5 %) having the first recorded seizure more than 48 h following EEG initiation, and 2/8 (25 %) at more than 72 h following EEG initiation. High clinical grade was associated with poor outcome at time of hospital discharge; electrographic seizures were not associated with poor outcome.
CONCLUSIONS: Electrographic seizures occur at a relatively high rate in patients with non-traumatic SAH even after accounting for referral bias. The prolonged time to the first detected seizure in this cohort may reflect dynamic clinical features unique to the SAH population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Neurocritical care - 21(2014), 3 vom: 11. Dez., Seite 476-82 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
O'Connor, Kathryn L [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 10.07.2015 Date Revised 21.10.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1007/s12028-014-9974-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM237281368 |
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| 100 | 1 | |a O'Connor, Kathryn L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High risk for seizures following subarachnoid hemorrhage regardless of referral bias |
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| 500 | |a Date Completed 10.07.2015 | ||
| 500 | |a Date Revised 21.10.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: To investigate the frequency, predictors, and clinical impact of electrographic seizures in patients with high clinical or radiologic grade non-traumatic subarachnoid hemorrhage (SAH), independent of referral bias | ||
| 520 | |a METHODS: We compared rates of electrographic seizures and associated clinical variables and outcomes in patients with high clinical or radiologic grade non-traumatic SAH. Rates of electrographic seizure detection before and after institution of a guideline which made continuous EEG monitoring routine in this population were compared | ||
| 520 | |a RESULTS: Electrographic seizures occurred in 17.6 % of patients monitored expressly because of clinically suspected subclinical seizures. In unselected patients, seizures still occurred in 9.6 % of all cases, and in 8.6 % of cases in which there was no a priori suspicion of seizures. The first seizure detected occurred 5.4 (IQR 2.9-7.3) days after onset of subarachnoid hemorrhage with three of eight patients (37.5 %) having the first recorded seizure more than 48 h following EEG initiation, and 2/8 (25 %) at more than 72 h following EEG initiation. High clinical grade was associated with poor outcome at time of hospital discharge; electrographic seizures were not associated with poor outcome | ||
| 520 | |a CONCLUSIONS: Electrographic seizures occur at a relatively high rate in patients with non-traumatic SAH even after accounting for referral bias. The prolonged time to the first detected seizure in this cohort may reflect dynamic clinical features unique to the SAH population | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Westover, M Brandon |e verfasserin |4 aut | |
| 700 | 1 | |a Phillips, Michael T |e verfasserin |4 aut | |
| 700 | 1 | |a Iftimia, Nicolae A |e verfasserin |4 aut | |
| 700 | 1 | |a Buckley, Deidre A |e verfasserin |4 aut | |
| 700 | 1 | |a Ogilvy, Christopher S |e verfasserin |4 aut | |
| 700 | 1 | |a Shafi, Mouhsin M |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenthal, Eric S |e verfasserin |4 aut | |
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