[Early presentation of crises and the development of epilepsy in cerebral intra-parenchymatous hemorrhage].
METHODS
Of a total of 283 patients with spontaneous or hypertensive cerebral intraparenchymatous hemorrhage, 18 (6.3%), with no previous epilepsy, had crises whilst being followed-up for a period of between 2 and 7 years. In 14 cases the hematoma was lobar and 4 involved the basal ganglia or thalamus. In 8 cases (2.8% of all hemorrhage), these crises occurred during the first 24 hours, or as a first symptom of intraparenchymatous hemorrhage. One patient presented with status epilepticus with generalized crises and two had subentrant secondarily generalized partial crises at the time of the ictus. Treatment with anti-epileptic drugs was started in 13 patients. Twelve patients (4.2% of the hemorrhages) developed symptomatic epilepsy with partial crises with or without secondary generalization.


CONCLUSIONS
The maximum rate of recurrence was four crises per year. However, in one patient, reduction of the dose of medication led to the appearance of status epilepticus. Patients with crises of late onset developed epilepsy more often than those who had early crises. In those with crises there was a predominance of bilobular involvement with participation of the parietal lobe and extension of the hematoma or oedema to the cerebral cortex.
Pérez López-Fraile
I
I
Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España.
Martín-Martínez
J
J
Bestué
M
M
Oliveros
A
A
D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D018450:Disease Progression; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed