Berger A R, Lipton R B, Lesser M L, Lantos G, Portenoy R K
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
Neurology. 1988 Sep;38(9):1363-5. doi: 10.1212/wnl.38.9.1363.
Seizures occurred in 19 of 112 patients (17%) with nontraumatic, supratentorial intracerebral hemorrhage (ICH). All seizures occurred at ICH onset; patients without seizures at hemorrhage onset remained seizure-free until the last recorded follow-up. Seizures were significantly associated with extension of blood into the cerebral cortex. We found no association between seizures and hemorrhage size or the presence of subarachnoid or intraventricular blood. These data suggest that (1) seizures, in ICH, occur at hemorrhage onset, (2) patients without seizures at hemorrhage onset are at very low risk for subsequent seizures during their hospitalization, (3) hemorrhage involving the cerebral cortex, regardless of site of origin, predisposes to seizures, and (4) the prophylactic use of anticonvulsants in the acute management of these patients appears unwarranted, especially in patients without cortical extension.
112例非创伤性幕上脑出血（ICH）患者中有19例（17%）发生了癫痫发作。所有癫痫发作均发生在脑出血发病时；出血发病时无癫痫发作的患者在最后一次记录的随访前均未再发生癫痫。癫痫发作与血液扩展至大脑皮质显著相关。我们未发现癫痫发作与出血大小或蛛网膜下腔或脑室内出血之间存在关联。这些数据表明：（1）脑出血患者的癫痫发作发生在出血发病时；（2）出血发病时无癫痫发作的患者在住院期间随后发生癫痫的风险非常低；（3）无论出血起源部位如何，累及大脑皮质的出血易引发癫痫；（4）在这些患者的急性治疗中预防性使用抗惊厥药物似乎没有必要，尤其是对于没有皮质扩展的患者。
