Early seizures after intracerebral hemorrhage predict drug-resistant epilepsy

Bianca T. A. de Greef, Floris H. B. M. Schreuder, Marielle C. G. Vlooswijk, A. H. C. M. L. Schreuder, Fergus A. Rooyer, Robert J. van Oostenbrugge, Rob P. W. Rouhl*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Seizures are a common complication after an intracerebral hemorrhage (ICH) and the epilepsy might even be drug resistant. It is not known which factors determine the treatment response in post-ICH epilepsy. We included ICH patients retrospectively who survived at least the first 7 days, in the period from 2004 to 2009 and assessed seizure occurrence up to May 2013. We defined early seizures (ES) as seizures occurring within the first 7 days after the ICH, and late seizures (LS) as seizures occurring later than 7 days after the ICH. We defined drug-resistant epilepsy as a non-response to two adequately chosen and dosed drug regimens. In 857 patients surviving at least 7 days after ICH 69 (8.1 %), patients developed ES whereas LS occurred in 84 (9.8 %) subjects. Patients with ES had higher odds to develop LS, as compared to patients without ES [OR 3.4; 95 % confidence interval (CI) 2.1-5.6]. Drug-resistant post-ICH epilepsy occurred in 19 patients (22.6 %). The most important independent risk factor was the occurrence of ES (OR 3.0; 95 %-CI 1.1-8.4). ES are the main independent risk factor for the development of LS and for the development of drug-resistant epilepsy. Thus, ES might hallmark the start of chronic epilepsy after intracerebral hemorrhage and are not to be considered of no significance.
Original languageEnglish
Pages (from-to)541-546
JournalJournal of Neurology
Issue number3
Publication statusPublished - Mar 2015


  • Post-hemorrhage seizures
  • Post-hemorrhage epilepsy
  • Early seizures
  • Drug-resistant epilepsy


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