Factors Associated to Epilepsy Development After Spontaneous Intracerebral Hemorrhage
Abstract number :
1.319
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2024
Submission ID :
887
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Daniel Campos-Fernandez, MD – Vall d'Hebron University Hospital
Lidia Girame-Rizzo, MD – Vall d’Hebron University Hospital
Olalla Pancorbo, MSN – Vall d'Hebron University Hospital
David Rodriguez-Luna, PhD – Vall d'Hebron University Hospital
Manuel Quintana, PhD – Vall d'Hebron University Hospital
Samuel López-Maza, MD – Vall d'Hebron University Hospital
Elena Fonseca, MD, PhD – Vall d'Hebron University Hospital
Manuel Toledo, MD, PhD – Vall d'Hebron University Hospital
Estevo Santamarina, MD, PhD – Vall d'Hebron University Hospital
Laura Abraira, MD PhD – Epilepsy Unit, Department of Neurology, Vall d’Hebron Hospital Universitari, Barcelona; Universitat Autonoma de Barcelona, Bellaterra, Spain
Rationale: The development of epilepsy after spontaneous intracerebral hemorrhage (ICH) has been associated with a worse functional prognosis and impaired quality of life. Our aim is to describe early predictors of epilepsy after ICH in order to guide follow-up and management of these patients.
Methods: This is a retrospective longitudinal study of adult patients with spontaneous ICH admitted to our center between January 2018 and May 2023. We collected clinical and neuroimaging variables, early onset seizures (EOS, ≤7 days from the bleeding) and development of epilepsy. Epilepsy was defined as the occurrence of remote unprovoked seizures >7 days after ICH onset. Previous structural brain lesion, epilepsy or ≤7-day follow-up (death, early transfer to another care facility) were exclusion criteria. Functional disability was assessed with the modified Rankin Score (mRS) at 3 months.
Results: We included 234 patients with a median follow-up of 2.5 years. The mean age was 70.5 (+/-14.0) years, 148 (63.2%) were male, and 28 (12.0%) developed epilepsy with a median latency of 329 days (IQR 60-777).
The early factors significantly associated with epilepsy development were a baseline NIHSS score >12 (p=0.032), EOS occurrence (p=0.019), non-hypertensive etiology (p< 0.001) and larger ICH volume (p< 0.001). ICH volume also allowed to stratify patients into 3 risk groups with good predictive capability (AUC 0.81, 95%CI 0.67-0.96): < 15mL (3.3% remote seizures), 15-30mL (17.9%) and >30mL (38.1%) [Figure 1].
Post-ICH epilepsy was associated with greater functional disability (3-month mRS ≥2, p=0.019).
Conclusions: Higher clinical severity, hematoma extension and etiology are risk factors for the development of epilepsy after spontaneous ICH. Post-ICH epilepsy is associated with functional disability, advising for a close follow-up of this group of patients.
Funding: None
Clinical Epilepsy