Abstract
Background and Purpose: Spontaneous intracerebral hemorrhage (ICH) can induce epileptic seizures. This study aimed to identify the incidence and risk factors of seizures in patients with ICH. We also investigated whether surgical intervention for hematoma was correlated with the occurrence of seizures.
Methods: A total of 478 adult patients (237 males, 241 females; age 23-101 years) enrolled in this study. Sixty-nine patients underwent removal of hematoma by craniotomy or stereotactic aspiration. Univariate and multivariate logistic regression analyses were used to assess the association of clinical factors with epileptic seizures.
Results: Seizures occurred in 26 (5.4%) patients with ICH, including early seizures (within 7 days of ICH) in 13 and late seizures (occurring >7 days after ICH) in 13. Univariate analysis revealed that hematoma in any lobe was significantly correlated with seizures. Multivariate analysis revealed that hematomas in the frontal lobe (odds ratio [OR]: 11.15; 95% confidence interval [CI]: 2.94-42.24; p = 0.0004), temporal lobe (OR: 3.49; 95% CI: 1.23-9.89; p = 0.0187), and occipital lobe (OR: 6.41; 95% CI: 1.48-27.83; p = 0.0131) were significantly correlated with seizures. Surgical intervention for hematoma was not associated with seizures. Eleven (84.6%) of 13 patients with late seizures went on to experience recurrent seizures, in contrast to only 2 (15.4%) of 13 with early seizures.
Conclusions: Cortical involvement of ICH was a risk factor of seizures. Surgical intervention for ICH did not influence occurrence of seizures. Late seizures are liable to recurrence, are compatible with unprovoked seizures, and may be diagnosed as epilepsy after a first seizure.
