title: Seizures and antiepileptic drugs in patients with spontaneous intracerebral hemorrhages.
abstract: OBJECTIVE
  Patients with intracerebral hemorrhage (ICH) are often initiated on antiepileptic drugs without a clear indication. We compared the percentage of patients with spontaneous ICH who had seizures at onset or during hospitalization, and examined empiric use of antiepileptic drugs (AEDs) in these patients in 2 cohorts 10 years apart.
  
  
  METHODS
  Using a clinical data registry at a tertiary care adult hospital, we retrospectively selected admissions for spontaneous ICH between 1/1/99-12/31/00 (Cohort A, n=30) and 1/1/09-12/31/10 (Cohort B, n=108). Clinical, neurophysiological and radiological data were collected in both cohorts.
  
  
  RESULTS
  In Cohorts A and B respectively, AEDs were started in 53.3% and 50.0%, and continued on discharge in 50.0% and 20.4% of patients; 86.6% and 59.1% of patients discharged on AEDs did not have a clinical/electrographic seizure or epileptiform EEG findings. Seizures occurred in 6.6% and 13.0% in Cohorts A and B respectively. The presence of a seizure at presentation (p=0.01) and during hospitalization (p=0.02) were predictors for continuing AED on discharge.
  
  
  CONCLUSIONS
  In both cohorts, a significant number of patients were discharged on AEDs without a clear indication, though there is a change in practice between the two cohorts.
authors: The Neurological Institute of New York, Columbia University Medical Center, New York, NY 10032, United States.
authors: Shraddha
authors: S
authors: Srinivasan
authors: Haewon
authors: H
authors: Shin
authors: Sherry H-Y
authors: SH
authors: Chou
authors: Page B
authors: PB
authors: Pennell
authors: Barbara A
authors: BA
authors: Dworetzky
authors: Jong Woo
authors: JW
authors: Lee
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000150:complications*; D015331:Cohort Studies; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012640:Seizures / Q000188:drug therapy* / Q000209:etiology*; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Continuous EEG; Seizures; Spontaneous intracerebral hemorrhage
references: Lancet. 2005 Jun 11-17;365(9476):2007-13
references: 15950714
references: Neurology. 2007 Sep 25;69(13):1356-65
references: 17893296
references: Neurocrit Care. 2010 Apr;12(2):165-72
references: 19898966
references: Arch Neurol. 2000 Nov;57(11):1617-22
references: 11074794
references: Neurology. 2008 Aug 26;71(9):665-9
references: 18725591
references: Stroke. 2007 Jun;38(6):2001-23
references: 17478736
references: Neurocrit Care. 2009;11(1):38-44
references: 19319701
references: AMIA Annu Symp Proc. 2006;:1044
references: 17238663
references: Rev Neurol Dis. 2008 Fall;5(4):178-81
references: 19122570
references: Neurology. 2003 May 13;60(9):1441-6
references: 12743228
references: Stroke. 1999 Apr;30(4):905-15
references: 10187901
references: Stroke. 2010 Sep;41(9):2108-29
references: 20651276
references: Epilepsia. 2008 Jun;49(6):974-81
references: 18248443
references: Stroke. 1996 Aug;27(8):1304-5
references: 8711791
references: Epilepsy Res. 2011 Aug;95(3):227-31
references: 21632213
references: Stroke. 2005 Mar;36(3):583-7
references: 15662039
references: Stroke. 2009 Dec;40(12):3810-5
references: 19797183
references: Epilepsia. 2002 Oct;43(10):1175-80
references: 12366733
references: Neurology. 2004 May 25;62(10):1743-8
references: 15159471