Araştırma Makalesi
PDF Zotero Mendeley EndNote BibTex Kaynak Göster

İntrakraniyal Kanamalar Sonrasında Oluşan Epileptik Nöbetin Erken Dönem Mortalite Üzerine Etkisi

Yıl 2022, Cilt 12, Sayı 2, 349 - 354, 15.03.2022
https://doi.org/10.16899/jcm.1067823

Öz

Giriş: İntrakraniyal kanamalar (İKK) akut fazda genellikle hematomun ve çevreleyen ödemin nöronal iletim üzerindeki yıkıcı etkisini gösteren epilepsi gibi komplikasyonlar açısından uzun dönem morbidite ve morbidite için yüksek risk altında kalmaktadır. Epileptik nöbet, İKK sonrasında akut ve uzun dönemde sık görülen durumlardan biridir. Çalışmamızda, İKK sonrasında görülen epileptik nöbetin erken dönem mortalite üzerine etkisini tespit edip literatüre bilgi sağlamayı amaçladık. Methods: Çalışmamı retrospektif olarak yapıldı. Çalışmaya dahil edilme kriterlerini karşılayan 238 kesinleşmiş İKK tanılı hasta çalışmaya dahil edildi. Nöbetin erken dönem ve geç dönem olarak sınıflandırmasında; kanama sonrası 14. güne kadar erken nöbet; 14. gün ve üzeri süreçte görülen nöbet ise geç dönem nöbet olarak sınıflandırıldı. Results: Olguların demografik verilerinde; nöbet + olanlarda yaş ortanca değeri 69,0 yıl; nöbet – olgularda yaş ortanca değeri 69,0 ve tüm olgularda ise yaş ortanca değeri 69 yıl olup; gruplar arasında yaş açısından anlamlı fark tespit edilmedi. Nöbet + olguların %57,7’si erkek; nöbet – olguların %52,7’si erkek olup cinsiyet açısından da gruplar farklı değildi. Nöbet tipinin 30 günlük mortalite üzerine etkisi incelendiğinde ise geç dönem nöbet geçiren olgularda mortalitenin anlamlı olarak yüksek olduğu görüldü Conclusions: İKK sonrasında görülen epileptik nöbetin mortalite üzerine etkisinin olduğunu tespit ettik. Bu nedenle nöbet geçiren olgularda mortalite açısından dikkatli olmak gerekmektedir. Özellikle geç dönem nöbet görülen olgularda mortalite erken dönem nöbet geçiren olgulara göre daha fazla olduğundan geç dönem nöbet görülen olgularda mortalite açısından dikkatli olmak gerekmektedir. Ayrıca antiepileptik ilaç kullanımının mortalite üzerine etki etmediğini tespit ettik. Daha kapsamlı çalışmalar yapılması ile bu konuda daha net bilgilerin elde edileceğini düşünmekteyiz.

Kaynakça

  • 1. Telefarlı MA, Akman C, Akdur O, Çakır A. The effect of blood lactate level on prognosis in cerebrovascular disease. Ann Clin Anal Med 2020; DOI: 10.4328/ACAM.20171
  • 2. van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ (2010) Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol 9(2):167–176. https ://doi.org/10.1016/S1474 -4422(09)70340-0
  • 3. Poon MT, Fonville AF, Al-Shahi Salman R (2014) Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 85(6):660–667. https ://doi.org/10.1136/jnnp-2013-306476
  • 4. Beghi E, D’Alessandro R, Beretta S, Consoli D, Crespi V, Delaj L, Gandolfo C, Greco G, La Neve A, Manfredi M, Mattana F, Musolino R, Provinciali L, Santangelo M, Specchio LM, Zaccara G, Epistroke G (2011) Incidence and predictors of acute symptomatic seizures after stroke. Neurology 77(20):1785–1793. https://doi.org/10.1212/WNL.0b013 e3182 364878
  • 5. Biffi A, Rattani A, Anderson CD, Ayres AM, Gurol EM, Greenberg SM, Rosand J, Viswanathan A (2016) Delayed seizures after intracerebral haemorrhage. Brain 139(Pt 10):2694–2705. https ://doi.org/10.1093/brain /aww199
  • 6. Rossi C, De Herdt V, Dequatre-Ponchelle N et al., Incidence and predictors of late seizures in intracerebral hemorrhages. Stroke 2013;44(6): 1723–5
  • 7. Beghi E, Carpio A, Forsgren L et al., Recommendation for a definition of acute symptomatic seizure. Epilepsia 2010;51(4):671–5.
  • 8. Claessens D, Bekelaar K, Schreuder FHBM, et al. Mortality after primary intracerebral hemorrhage in relation to post-stroke seizures. J Neurol. 2017;264(9):1885-1891. Doi:10.1007/s00415-017-8573-1.
  • 9. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-521. doi:10.1111/epi.13709.
  • 10. Szaflarski JP, Rackley AY, Kleindorfer DO, et al. Incidence of seizures in the acute phase of stroke: a population-based study. Epilepsia. 2008;49(6):974-981. doi:10.1111/j.1528-1167.2007.01513.x
  • 11. Vespa PM, O’Phelan K, Shah M, Mirabelli J, Starkman S, Kidwell C, Saver J, Nuwer MR, Frazee JG, McArthur DA, Martin NA. Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology. 2003; 60:1441–1446.
  • 12. Labovitz DL, Hauser WA, Sacco RL. Prevalence and predictors of early seizure and status epilepticus after first stroke. Neurology. 2001; 57:200–206.
  • 13. Brüning T, Awwad S, Al-Khaled M. Do early seizures indicate survival of patients with nontraumatic intracerebral hemorrhage? Cerebrovasc Dis. 2016; 41:68-73.
  • 14. Mehta A, Zusman BE, Choxi R, et al. Seizures After Intracerebral Hemorrhage: Incidence, Risk Factors, and Impact on Mortality and Morbidity. World Neurosurg. 2018;112: e385-e392. doi: 10.1016/j.wneu.2018.01.052.
  • 15. Gilad R, Boaz M, Dabby R, Sadeh M, Lampl Y. Are post intracerebral hemorrhage seizures prevented by anti-epileptic treatment? Epilepsy Res. 2011;95(3):227–231. doi: 10.1016/j.eplepsyres.2011.04.002.

The Effect of Epileptic Seizure Occurring After Intracranial Hemorrhages on Early Mortality

Yıl 2022, Cilt 12, Sayı 2, 349 - 354, 15.03.2022
https://doi.org/10.16899/jcm.1067823

Öz

Introduction: Intracranial hemorrhages (ICH) are at high risk for long-term morbidity and morbidity in terms of complications such as epilepsy. In our study, we aimed to determine the effect of epileptic seizure seen after ICH on early mortality and to provide information to the literature. Methods: My study was done retrospectively. A total of 238 patients with a confirmed diagnosis of ICH who met the inclusion criteria were included in the study. In the classification of the seizure as early and late; early seizure up to the 14th day after bleeding; Seizures observed on the 14th day and above were classified as late seizures. Results: In the demographic data There was no significant difference between the groups in terms of age. Seizure + 57.7% of cases were male; seizure – 52.7% of the cases were male and the groups were not different in terms of gender. When the effect of seizure type on 30-day mortality was examined, it was observed that mortality was significantly higher in cases with late seizures. Conclusions: We determined that the epileptic seizure seen after ICH has an effect on mortality. Therefore, it is necessary to be careful in terms of mortality in cases with seizures. Especially in cases with late seizures, mortality is higher than in cases with early seizures, so it is necessary to be careful in terms of mortality in cases with late seizures. In addition, we found that the use of antiepileptic drugs did not affect mortality.

Kaynakça

  • 1. Telefarlı MA, Akman C, Akdur O, Çakır A. The effect of blood lactate level on prognosis in cerebrovascular disease. Ann Clin Anal Med 2020; DOI: 10.4328/ACAM.20171
  • 2. van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ (2010) Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol 9(2):167–176. https ://doi.org/10.1016/S1474 -4422(09)70340-0
  • 3. Poon MT, Fonville AF, Al-Shahi Salman R (2014) Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 85(6):660–667. https ://doi.org/10.1136/jnnp-2013-306476
  • 4. Beghi E, D’Alessandro R, Beretta S, Consoli D, Crespi V, Delaj L, Gandolfo C, Greco G, La Neve A, Manfredi M, Mattana F, Musolino R, Provinciali L, Santangelo M, Specchio LM, Zaccara G, Epistroke G (2011) Incidence and predictors of acute symptomatic seizures after stroke. Neurology 77(20):1785–1793. https://doi.org/10.1212/WNL.0b013 e3182 364878
  • 5. Biffi A, Rattani A, Anderson CD, Ayres AM, Gurol EM, Greenberg SM, Rosand J, Viswanathan A (2016) Delayed seizures after intracerebral haemorrhage. Brain 139(Pt 10):2694–2705. https ://doi.org/10.1093/brain /aww199
  • 6. Rossi C, De Herdt V, Dequatre-Ponchelle N et al., Incidence and predictors of late seizures in intracerebral hemorrhages. Stroke 2013;44(6): 1723–5
  • 7. Beghi E, Carpio A, Forsgren L et al., Recommendation for a definition of acute symptomatic seizure. Epilepsia 2010;51(4):671–5.
  • 8. Claessens D, Bekelaar K, Schreuder FHBM, et al. Mortality after primary intracerebral hemorrhage in relation to post-stroke seizures. J Neurol. 2017;264(9):1885-1891. Doi:10.1007/s00415-017-8573-1.
  • 9. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-521. doi:10.1111/epi.13709.
  • 10. Szaflarski JP, Rackley AY, Kleindorfer DO, et al. Incidence of seizures in the acute phase of stroke: a population-based study. Epilepsia. 2008;49(6):974-981. doi:10.1111/j.1528-1167.2007.01513.x
  • 11. Vespa PM, O’Phelan K, Shah M, Mirabelli J, Starkman S, Kidwell C, Saver J, Nuwer MR, Frazee JG, McArthur DA, Martin NA. Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology. 2003; 60:1441–1446.
  • 12. Labovitz DL, Hauser WA, Sacco RL. Prevalence and predictors of early seizure and status epilepticus after first stroke. Neurology. 2001; 57:200–206.
  • 13. Brüning T, Awwad S, Al-Khaled M. Do early seizures indicate survival of patients with nontraumatic intracerebral hemorrhage? Cerebrovasc Dis. 2016; 41:68-73.
  • 14. Mehta A, Zusman BE, Choxi R, et al. Seizures After Intracerebral Hemorrhage: Incidence, Risk Factors, and Impact on Mortality and Morbidity. World Neurosurg. 2018;112: e385-e392. doi: 10.1016/j.wneu.2018.01.052.
  • 15. Gilad R, Boaz M, Dabby R, Sadeh M, Lampl Y. Are post intracerebral hemorrhage seizures prevented by anti-epileptic treatment? Epilepsy Res. 2011;95(3):227–231. doi: 10.1016/j.eplepsyres.2011.04.002.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Adem ÇAKIR
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ACİL TIP ANABİLİM DALI
0000-0002-4966-4882
Türkiye


Ejder Saylav BORA (Sorumlu Yazar)
İZMİR SAĞLIK BAKANLIĞI İZMİR KATİP ÇELEBİ ÜNİVERSİTESİ ATATÜRK EĞİTİM VE ARAŞTIRMA HASTANESİ, ACİL TIP
0000-0002-2448-2337
Türkiye

Erken Görünüm Tarihi 1 Ocak 2022
Yayımlanma Tarihi 15 Mart 2022
Kabul Tarihi 2 Mart 2022
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 2

Kaynak Göster

AMA Çakır A. , Bora E. S. The Effect of Epileptic Seizure Occurring After Intracranial Hemorrhages on Early Mortality. J Contemp Med. 2022; 12(2): 349-354.