PMID- 35411540
OWN - NLM
STAT- MEDLINE
DCOM- 20220519
LR  - 20220901
IS  - 1556-0961 (Electronic)
IS  - 1541-6933 (Print)
IS  - 1541-6933 (Linking)
VI  - 36
IP  - 3
DP  - 2022 Jun
TI  - Impact of Seizures and Status Epilepticus on Outcome in Patients with Aneurysmal 
      Subarachnoid Hemorrhage.
PG  - 751-759
LID - 10.1007/s12028-022-01489-0 [doi]
AB  - BACKGROUND: We aimed to evaluate the association between seizures as divided by 
      timing and type (seizures or status epilepticus) and outcome in patients with 
      aneurysmal subarachnoid hemorrhage (aSAH). METHODS: All consecutive patients with 
      aSAH admitted to the neurocritical care unit of the University Hospital Zurich 
      between 2016 and 2020 were included. Seizure type and frequency were extracted 
      from electronic patient files. RESULTS: Out of 245 patients, 76 experienced acute 
      symptomatic seizures, with 39 experiencing seizures at onset, 18 experiencing 
      acute seizures, and 19 experiencing acute nonconvulsive status epilepticus 
      (NCSE). Multivariate analysis revealed that acute symptomatic NCSE was an 
      independent predictor of unfavorable outcome (odds ratio 14.20, 95% confidence 
      interval 1.74-116.17, p = 0.013) after correction for age, Hunt-Hess grade, 
      Fisher grade, and delayed cerebral ischemia. Subgroup analysis showed a 
      significant association of all seizures/NCSE with higher Fisher grade (p < 0.001 
      for acute symptomatic seizures/NCSE, p = 0.031 for remote symptomatic seizures). 
      However, although acute seizures/NCSE (p = 0.750 and 0.060 for acute 
      seizures/NCSE respectively) were not associated with unfavorable outcome in 
      patients with a high Hunt-Hess grade, they were significantly associated with 
      unfavorable outcome in patients with a low Hunt-Hess grade (p = 0.019 and 
      p < 0.001 for acute seizures/NCSE, respectively). CONCLUSIONS: Acute symptomatic 
      NCSE independently predicts unfavorable outcome after aSAH. Seizures and NCSE are 
      associated with unfavorable outcome, particularly in patients with a low 
      Hunt-Hess grade. We propose that NCSE and the ictal or postictal reduction of 
      Glasgow Coma Scale may hamper close clinical evaluation for signs of delayed 
      cerebral ischemia, and thus possibly leading to delayed diagnosis and therapy 
      thereof in patients with a low Hunt-Hess grade.
CI  - (c) 2022. The Author(s).
FAU - Bogli, Stefan Yu
AU  - Bogli SY
AUID- ORCID: 0000-0001-5386-0811
AD  - Institute for Intensive Care Medicine, University Hospital Zurich, 
      Frauenklinikstrasse 26, 8091, Zurich, Switzerland. stefanyu.boegli@usz.ch.
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland. 
      stefanyu.boegli@usz.ch.
AD  - Clinical Neuroscience Center, University Hospital and University of Zurich, 
      Zurich, Switzerland. stefanyu.boegli@usz.ch.
FAU - Wang, Sophie
AU  - Wang S
AD  - Institute for Intensive Care Medicine, University Hospital Zurich, 
      Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
AD  - Department of Neurosurgery and Neurotechnology, Eberhard Karls University 
      Tubingen, Tubingen, Germany.
FAU - Romaguera, Natalia
AU  - Romaguera N
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
FAU - Schutz, Valerie
AU  - Schutz V
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
FAU - Rafi, Omar
AU  - Rafi O
AD  - Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
FAU - Gilone, Marco
AU  - Gilone M
AD  - Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
FAU - Keller, Emanuela
AU  - Keller E
AD  - Institute for Intensive Care Medicine, University Hospital Zurich, 
      Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
AD  - Clinical Neuroscience Center, University Hospital and University of Zurich, 
      Zurich, Switzerland.
AD  - Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
FAU - Imbach, Lukas L
AU  - Imbach LL
AD  - Swiss Epilepsy Center, Klinik Lengg AG, Zurich, Switzerland.
FAU - Brandi, Giovanna
AU  - Brandi G
AD  - Institute for Intensive Care Medicine, University Hospital Zurich, 
      Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20220412
PL  - United States
TA  - Neurocrit Care
JT  - Neurocritical care
JID - 101156086
SB  - IM
CIN - Neurocrit Care. 2022 Jun;36(3):699-701. PMID: 35396642
MH  - *Brain Ischemia/complications/therapy
MH  - Cerebral Infarction/complications
MH  - Humans
MH  - Retrospective Studies
MH  - Seizures/etiology
MH  - *Status Epilepticus/etiology/therapy
MH  - *Subarachnoid Hemorrhage/complications/diagnosis/therapy
PMC - PMC9110510
OTO - NOTNLM
OT  - Aneurysmal subarachnoid hemorrhage
OT  - Outcome
OT  - Status epilepticus
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2022/04/13 06:00
MHDA- 2022/05/20 06:00
PMCR- 2022/04/12
CRDT- 2022/04/12 05:32
PHST- 2021/11/18 00:00 [received]
PHST- 2022/03/14 00:00 [accepted]
PHST- 2022/04/13 06:00 [pubmed]
PHST- 2022/05/20 06:00 [medline]
PHST- 2022/04/12 05:32 [entrez]
PHST- 2022/04/12 00:00 [pmc-release]
AID - 10.1007/s12028-022-01489-0 [pii]
AID - 1489 [pii]
AID - 10.1007/s12028-022-01489-0 [doi]
PST - ppublish
SO  - Neurocrit Care. 2022 Jun;36(3):751-759. doi: 10.1007/s12028-022-01489-0. Epub 
      2022 Apr 12.