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Retrospective Analysis of Continuous EEG in Spontaneous Intracerebral Hemorrhage: A Study from Central India

Dinesh Chouksey, Assistant Professor, Neurology Department, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh 453555, India. , Sunil Athale , Dinesh Chouksey , Rahul Jain , Akshay N Lakhotia

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Indian Journal of Emergency Medicine 4(3):p 131-136, Jul-Sep, 2018. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.4318.3

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Abstract

Background: Intracerebral hemorrhage (ICH) is a neurological emergency and it is the most severe form of acute stroke, accounting for 15–25% of all strokes, and 50% of stroke mortality [1,2]. The intracerebral hemorrhage complicated by seizures is often a life threatening condition. The subclinical seizures (Electrographic seizure) also gained attention even if they are infrequent, to prevent further ongoing neuronal damage [3]. EEG provides insight into the thalamocortical functions in patients with impaired consciousness and will help to detect the subclinical seizures before clinical manifestation and at the time of reversible stage. Role of prophylactic antiepileptic in ICH is still a matter of discussion. Subclinical seizures are identified with the help of continuous EEG monitoring. The goal of our study is to look for the EEG changes in different ICH locations and identification of electrographic seizures.

Aim: To look for EEG changes in different locations of ICH and to identify the electrographic seizures.

Method: A Retrospective observational study of 46 patients of ICH admitted in Department of Neurology, SAMC and PGI, Indore from January 2012 to March 2017.

Result: Total 16 patients (35%) had EEG abnormalities, 8 of them having abnormal epileptiform activities and rest 8 were having generalized low amplitude fast Beta activity. The electrographic seizures were seen in 4 patients (9%) and all of them having subcortical bleed. Two patient of cortical bleed had clinical seizures and were showing abnormal epileptiform activities in EEG record. Commonest site of ICH in our study was Basal ganglia and commonest cause is hypertension.

Conclusion: The continuous EEG monitoring in ICH patients is cost effective to identify subclinical seizures because they are detrimental to these patients. Our observation suggests it is better to use prophylactic antiepileptic drugs in lobar bleeds.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.4318.3

Keywords

EEG in ICH; Nonconvulsive Seizures in ICH; Antiepileptic Drugs Inich; Seizures in ICH; Subclinical Seizure

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