Subarachnoid Hemorrhage-Related Epilepsy

Boling, Warren; Kore, Lydia

doi:10.1007/978-3-030-04615-6_4

Cited by 5 publications

(6 citation statements)

References 31 publications

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“…The analysis of the neuroradiological characteristics of the study population demonstrates that cSS, whether focal or disseminated, and CAA‐ri are predisposing factors for the development of epilepsy. Even if the pathogenetic mechanisms leading to the development of seizures in CAA are not known, it is conceivable that hemosiderin deposition at the cortical level (leading to cSS) could exert a proepileptogenic irritative effect 34,35 . Moreover, because CAA‐ri seems to be mediated by anti‐Aβ autoantibodies, 7,8 an immune‐mediated process responsible for the onset of seizures could be involved, similarly to autoimmune encephalitis 36 …”

Section: Discussionmentioning

confidence: 99%

“…Even if the pathogenetic mechanisms leading to the development of seizures in CAA are not known, it is conceivable that hemosiderin deposition at the cortical level (leading to cSS) could exert a proepileptogenic irritative effect. 34,35 Moreover, because CAA-ri seems to be mediated by anti-Aβ autoantibodies, 7,8 an immune-mediated process responsible for the onset of seizures could be involved, similarly to autoimmune encephalitis. 36 These data lead to further considerations.…”

Section: Discussionmentioning

confidence: 99%

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Epilepsy in cerebral amyloid angiopathy: an observational retrospective study of a large population

et al. 2023

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Objective: Cerebral amyloid angiopathy (CAA) is a major cause of spontaneous intracranial hemorrhage in older adults. Epilepsy represents a possible sequela of the disease. To date, studies on epilepsy in CAA are lacking, and the few data available mainly focus on CAA-related inflammation (CAA-ri), the inflammatory form of the disease. Methods:In this retrospective observational study, we consecutively recruited CAA patients observed over a time span of 10 years, collecting demographic, clinical, and instrumental data. Significant baseline characteristics were evaluated as potential risk factors for the development of epilepsy in the CAA population, and in the subgroups of CAA-ri and CAA without inflammatory reaction (CAA-nri).The effect of potential risk factors for epilepsy was measured as odds ratio with 95% confidence interval.Results: Within 96 recruited CAA cases, 33 (34.4%) developed epilepsy during follow-up (median = 13.5 months). The prevalent type of seizure was focal (81.3%); 12.1% of the epileptic patients presented status epilepticus, and 6.1% developed drug-resistant epilepsy. Electroencephalographic traces revealed slow and epileptic discharge activity in the majority of epileptic patients, but also in those without epilepsy. The presence of focal or disseminated cortical superficial siderosis (cSS) was associated with an increased risk of epilepsy in the CAA-nri group, and the association with CAA-ri and epilepsy was present in the overall population.Significance: Epilepsy is a common manifestation during the course of CAA, where CAA-ri and cSS represent predisposing factors for the development of seizures. These data suggest the importance of a deep characterization of CAA patients, to better select those more prone to develop epilepsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epilepsy in cerebral amyloid angiopathy: an observational retrospective study of a large population

et al. 2023

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“…As a severe complication of SAH, epilepsy increases mortality and disability rates ( 13 ). Although the underlying mechanisms of epilepsy after SAH remain unclear, several classes of risk factors have been reported to contribute to a greater risk of epilepsy after SAH, such as hemosiderin deposition, subarachnoid clot burden, hypertension, vasospasm, and acute hydrocephalus ( 3 , 14 , 15 ). Hemosiderin deposition in the brain and spinal cord due to hemorrhage into the subarachnoid space in some patients is considered to be a cause and key predictor of epilepsy after SAH ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, SAH combined with epilepsy leads to anxiety, depression, and other psychological problems, which may be worse than primary disease. However, the potential mechanisms of epilepsy secondary to SAH are still unclear (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Identification of hub genes significantly linked to subarachnoid hemorrhage and epilepsy via bioinformatics analysis

Gao

Li²,

Li³

et al. 2023

Front. Neurol.

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BackgroundAlthough epilepsy has been linked to subarachnoid hemorrhage (SAH), the underlying mechanism has not been fully elucidated. This study aimed to further explore the potential mechanisms in epilepsy and SAH through genes.MethodsGene expression profiles for subarachnoid hemorrhage (GSE36791) and epilepsy (GSE143272) were downloaded from the Gene Expression Omnibus (GEO) database. Differential expression analysis was performed to identify the common differentially expressed genes (DEGs) to epilepsy and SAH, which were further analyzed by functional enrichment analysis. Single-sample gene set enrichment analysis (ssGSEA) and weighted correlation network analysis (WGCNA) were used to identify common module genes related to the infiltration of immune cells in epilepsy and SAH. Hub module genes were identified using a protein–protein interaction (PPI) network. Finally, the most relevant genes were obtained by taking the intersection points between the DEGs and hub module genes. We performed validation by retrospectively analyzing the RT-PCR levels of the most relevant genes in patients with pure SAH and patients with SAH complicated with epilepsy. Our experiments verified that the SAH and SAH+epilepsy groups were significantly different from the normal control group. In addition, significant differences were observed between the SAH and SAH+epilepsy groups.ResultsIn total, 159 common DEGs–85 downregulated genes and 74 upregulated genes—were identified. Functional analysis emphasized that the immune response was a common feature to epilepsy and SAH. The results of ssGSEA and WGCNA revealed changes in immunocyte recruitment and the related module genes. Finally, MMP9 and C3aR1 were identified as hub genes, and RT-PCR confirmed that the expression levels of the hub genes were higher in epilepsy and SAH samples than in normal samples.ConclusionsOur study revealed the pathogenesis of SAH complicated with epilepsy and identified hub genes that might provide new ideas for further mechanistic studies.

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“…Early seizures after SAH occur most commonly in the first 24 hours [26]. The actuarial risk of epilepsy after SAH was 18% by the first year, 23% by the second year, and 25% by the fifth year in the survivors of SAH [28]. Aneurysm location most associated with the development of SAH-related epilepsy is middle cerebral artery at the M1 branch and artery bifurcation [66].…”

Section: Subarachnoid Hemorrhagementioning

confidence: 99%

Cerebrovascular Disease; A Leading Cause of Epilepsy

Obata¹,

Sato²,

Ohara³

et al. 2021

Epilepsy - Update on Classification, Etiologies, Instrumental Diagnosis and Treatment

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Various types of cerebrovascular diseases can result in epilepsy in any age, especially in the elderly. Besides well-known cause of epilepsy as large cerebral infarction involving cerebral cortex and intracerebral hemorrhage, there are growing evidences of roles of subcortical infarction, chronic subdural hematoma, and superficial siderosis of the central nervous system in the pathogenesis of epilepsy. We review here the epidemiology and possible predictors of epilepsy in each type of cerebrovascular lesions and summarize the characteristics of semiology and electroencephalography findings in order to take early treatment strategy. Additionally, relevance of acute-symptomatic seizures and status epilepticus to epilepsy is discussed.

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Subarachnoid Hemorrhage-Related Epilepsy

Cited by 5 publications

References 31 publications

Epilepsy in cerebral amyloid angiopathy: an observational retrospective study of a large population

Epilepsy in cerebral amyloid angiopathy: an observational retrospective study of a large population

Identification of hub genes significantly linked to subarachnoid hemorrhage and epilepsy via bioinformatics analysis

Cerebrovascular Disease; A Leading Cause of Epilepsy

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