Seizures and anticonvulsants after aneurysmal subarachnoid hemorrhage

Giuseppe Lanzino, Pietro Ivo D'Urso, Jose Suarez

Research output: Contribution to journalReview article

Abstract

Seizures and seizure-like activity may occur in patients experiencing aneurysmal subarachnoid hemorrhage. Treatment of these events with prophylactic antiepileptic drugs remains controversial. An electronic literature search was conducted for English language articles describing the incidence and treatment of seizures after aneurysmal subarachnoid hemorrhage from 1980 to October 2010. A total of 56 articles were included in this review. Seizures often occur at the time of initial presentation or aneurysmal rebleeding before aneurysm treatment. Seizures occur in about 2% of patients after invasive aneurysm treatment, with a higher incidence after surgical clipping compared with endovascular repair. Non-convulsive seizures should be considered in patients with poor neurological status or deterioration. Seizure prophylaxis with antiepileptic drugs is controversial, with limited data available for developing recommendations. While antiepileptic drug use has been linked to worse prognosis, studies have evaluated treatment with almost exclusively phenytoin. When prophylaxis is used, 3-day treatment seems to provide similar seizure prevention with better outcome compared with longer-term treatment.

Original languageEnglish (US)
Pages (from-to)247-256
Number of pages10
JournalNeurocritical Care
Volume15
Issue number2
DOIs
StatePublished - Oct 1 2011
Externally publishedYes

Fingerprint

Subarachnoid Hemorrhage
Anticonvulsants
Seizures
Therapeutics
Aneurysm
Incidence
Phenytoin
Language

Keywords

  • Antiepileptic drug
  • Epileptiform
  • Non-convulsive
  • Phenytoin
  • Seizure
  • Tonic

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Clinical Neurology

Cite this

Seizures and anticonvulsants after aneurysmal subarachnoid hemorrhage. / Lanzino, Giuseppe; D'Urso, Pietro Ivo; Suarez, Jose.

In: Neurocritical Care, Vol. 15, No. 2, 01.10.2011, p. 247-256.

Research output: Contribution to journalReview article

Lanzino, Giuseppe ; D'Urso, Pietro Ivo ; Suarez, Jose. / Seizures and anticonvulsants after aneurysmal subarachnoid hemorrhage. In: Neurocritical Care. 2011 ; Vol. 15, No. 2. pp. 247-256.
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