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Seizures in Intracerebral Hemorrhage

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Seizures in Cerebrovascular Disorders

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Abstract

Seizures are not infrequent among patients with intracerebral hemorrhage (ICH). Acutely, seizures in ICH are thought to be due to structural and biochemical disruption, whereas late seizures and epilepsy are likely related to inflammation and gliosis. Early seizures may occur in 3.4–41 % of patients and the risk of epilepsy is 2.3–31 % depending on the definitions used and time of follow-up. The frequency of seizures in ICH may be underestimated as a significant number of patients may have electrographic nonconvulsive seizures. While status epilepticus is generally uncommon in patients with ICH, it may represent 20 % among patients with ICH and seizures. Partial seizures or partial seizures with secondary generalization are the most common type. There are factors that increase the risk of seizures. There is conflicting evidence with regard to the impact of seizures on the outcome of ICH although it is clear that status epilepticus increases mortality rate. Evidence supporting the use of antiepileptic drugs in patients with ICH is scarce. There is general agreement that clinical and electrographic seizures should be treated and prophylactic therapy avoided; though, there is uncertainty with regard to the duration of therapy and its role in epilepsy prevention.

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Author information

Authors and Affiliations

  1. Department of Neurology, Texas Tech University Health Science Center at El Paso, 4800 Alberta Ave, 79905, El Paso, TX, USA

    Prof. Salvador Cruz-Flores MD, MPF

  2. SSM-Neurosciences Institute, DePaul Health Center and St. Louis University, 12255 DePaul Health Drive, Suite 200, 63044, St. Louis, Missouri, USA

    Assoc. Prof. Amer Alshekhlee MD, MSc

Authors
  1. Prof. Salvador Cruz-Flores MD, MPF
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  2. Assoc. Prof. Amer Alshekhlee MD, MSc
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Correspondence to Salvador Cruz-Flores MD, MPF .

Editor information

Editors and Affiliations

  1. Department of Neurology Director, Epilepsy Center, George Washington University, Washington DC, District of Columbia, USA

    Mohamad Z. Koubeissi

  2. SSM-Neurosciences Institute and St. Louis University, St. Louis University, Missouri, Missouri, USA

    Amer Alshekhlee

  3. Vascular Neurology Fellow, University of Virginia, Charlottesville, Virginia, Virginia, USA

    Prachi Mehndiratta

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Cruz-Flores, S., Alshekhlee, A. (2015). Seizures in Intracerebral Hemorrhage. In: Koubeissi, M., Alshekhlee, A., Mehndiratta, P. (eds) Seizures in Cerebrovascular Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2559-9_3

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  • DOI: https://doi.org/10.1007/978-1-4939-2559-9_3

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2558-2

  • Online ISBN: 978-1-4939-2559-9

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