Format

Send to

Choose Destination
Neurology. 2016 Jan 19;86(3):253-60. doi: 10.1212/WNL.0000000000002281. Epub 2015 Dec 23.

Seizure burden in subarachnoid hemorrhage associated with functional and cognitive outcome.

Author information

1
From the Department of Neurology (G.M.D.M., D.P., E.M., A.V., S.S., S.P., M.C.F., S.A., S.M., J.M.S., E.S.C., J.C.), Division of Neurocritical Care, College of Physicians and Surgeons, Columbia University, New York, NY; the Department of Neurology (G.M.D.M.), University Hospital Basel, Switzerland; and the Department of Medicine, Division of Neurology (S.S.), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
2
From the Department of Neurology (G.M.D.M., D.P., E.M., A.V., S.S., S.P., M.C.F., S.A., S.M., J.M.S., E.S.C., J.C.), Division of Neurocritical Care, College of Physicians and Surgeons, Columbia University, New York, NY; the Department of Neurology (G.M.D.M.), University Hospital Basel, Switzerland; and the Department of Medicine, Division of Neurology (S.S.), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. jc1439@mail.cumc.columbia.edu.

Abstract

OBJECTIVE:

To assess the relationship between seizure burden on continuous EEG (cEEG) and functional as well as cognitive outcome 3 months after subarachnoid hemorrhage (SAH).

METHODS:

The study included all consecutive patients with a spontaneous SAH admitted to the Columbia University Medical Center Neurological Intensive Care Unit and monitored with cEEG between 1996 and 2013. Seizure burden was defined as the duration, in hours, of seizures on cEEG. Cognitive outcomes were measured with the Telephone Interview for Cognitive Status (TICS, ranging from 0 to 51, indicating poor to good global mental status).

RESULTS:

Overall, 402 patients with SAH were included with a median age of 58 years (interquartile range [IQR] 46-68 years). The median duration of cEEG monitoring was 96 hours (IQR 48-155 hours). Seizures were recorded in 50 patients (12%), in whom the median seizure burden was 6 hours (IQR 1-13 hours). At 3 months, in multivariate analysis, seizure burden was associated with unfavorable functional and cognitive outcome. Every hour of seizure on cEEG was associated with an odds ratio of 1.10 (95% confidence interval [CI] 1.01-1.21, p = 0.04) to 3-month disability and mortality, and the TICS-score decreased, on average, by 0.16 points (adjusted coefficient -0.19, 95% CI -0.33 to -0.05, p = 0.01).

CONCLUSION:

In this study, after adjusting for established predictors, seizure burden was associated with functional outcome and cognitive impairment 3 months after SAH.

PMID:
26701381
PMCID:
PMC4733156
DOI:
10.1212/WNL.0000000000002281
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center