The Neurological Institute of New York, Columbia University Medical Center, New York, NY 10032, United States.
Seizure. 2013 Sep;22(7):512-6. doi: 10.1016/j.seizure.2013.03.011. Epub 2013 Apr 30.
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.
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.
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.
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.
脑出血（ICH）患者常因无明确指征而开始使用抗癫痫药物。我们比较了两个相隔 10 年的队列中，在发病时或住院期间出现癫痫发作的自发性 ICH 患者比例，并检查了这些患者中经验性使用抗癫痫药物（AED）的情况。
我们使用一家三级成人医院的临床数据登记系统，回顾性选择了 1999 年 1 月 1 日至 2000 年 12 月 31 日（队列 A，n=30）和 2009 年 1 月 1 日至 2010 年 12 月 31 日（队列 B，n=108）期间自发性 ICH 的入院患者。两个队列均收集了临床、神经生理学和影像学数据。
在队列 A 和 B 中，分别有 53.3%和 50.0%的患者开始使用 AED，分别有 50.0%和 20.4%的患者在出院时继续使用；在出院时使用 AED 的患者中，分别有 86.6%和 59.1%的患者没有临床/电癫痫发作或癫痫样脑电图发现。队列 A 和 B 中分别有 6.6%和 13.0%的患者出现癫痫发作。在发病时（p=0.01）和住院期间（p=0.02）出现癫痫是继续使用 AED 的出院预测因素。
在两个队列中，尽管两个队列之间的做法有所改变，但仍有相当数量的患者在没有明确指征的情况下出院时使用了 AED。
