Introduction: It is unclear which patients with non-traumatic (spontaneous) intracerebral haemorrhage (ICH) are at risk of developing acute symptomatic seizures (provoked seizures occurring within the first week after stroke onset; early seizures, ES) and whether ES predispose to the occurrence of remote symptomatic seizures (unprovoked seizures occurring more than 1 week after stroke; post-stroke epilepsy, PSE) and long-term mortality.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.Graphical abstract

Early seizures and risk of epilepsy and death after intracerebral haemorrhage: The MUCH Italy / 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. - In: EUROPEAN STROKE JOURNAL. - ISSN 2396-9881. - 9:3(2024), pp. 630-638. [10.1177/23969873241247745]

Early seizures and risk of epilepsy and death after intracerebral haemorrhage: The MUCH Italy

Pezzini, Alessandro
Conceptualization
;
Ferraro, Chiara
Membro del Collaboration Group
;
2024-01-01

Abstract

Introduction: It is unclear which patients with non-traumatic (spontaneous) intracerebral haemorrhage (ICH) are at risk of developing acute symptomatic seizures (provoked seizures occurring within the first week after stroke onset; early seizures, ES) and whether ES predispose to the occurrence of remote symptomatic seizures (unprovoked seizures occurring more than 1 week after stroke; post-stroke epilepsy, PSE) and long-term mortality.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.Graphical abstract
2024
Early seizures and risk of epilepsy and death after intracerebral haemorrhage: The MUCH Italy / 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. - In: EUROPEAN STROKE JOURNAL. - ISSN 2396-9881. - 9:3(2024), pp. 630-638. [10.1177/23969873241247745]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2997256
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact