文摘

Background To investigate the frequency, predictors, and clinical impact of electrographic seizures in patients with high clinical or radiologic grade non-traumatic subarachnoid hemorrhage (SAH), independent of referral bias. Methods We compared rates of electrographic seizures and associated clinical variables and outcomes in patients with high clinical or radiologic grade non-traumatic SAH. Rates of electrographic seizure detection before and after institution of a guideline which made continuous EEG monitoring routine in this population were compared. Results Electrographic seizures occurred in 17.6?% of patients monitored expressly because of clinically suspected subclinical seizures. In unselected patients, seizures still occurred in 9.6?% of all cases, and in 8.6?% of cases in which there was no a priori suspicion of seizures. The first seizure detected occurred 5.4 (IQR 2.9-.3) days after onset of subarachnoid hemorrhage with three of eight patients (37.5?%) having the first recorded seizure more than 48?h following EEG initiation, and 2/8 (25?%) at more than 72?h following EEG initiation. High clinical grade was associated with poor outcome at time of hospital discharge; electrographic seizures were not associated with poor outcome. Conclusions Electrographic seizures occur at a relatively high rate in patients with non-traumatic SAH even after accounting for referral bias. The prolonged time to the first detected seizure in this cohort may reflect dynamic clinical features unique to the SAH population.