{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:39:38Z","timestamp":1789072778048,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acute symptomatic seizures (ASyS) occur in up to 30% of patients with intracerebral hemorrhage (ICH) when continuous electroencephalography (cEEG) is used, potentially worsening outcomes. Identification of early EEG biomarkers of ASyS may help guide personalized antiseizure medication (ASM) prophylaxis. Here, we aimed to describe early interictal EEG patterns, their dynamics, and their association with seizure risk, considering the effect of prophylactic levetiracetam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective analysis used data from the PEACH phase 3 trial (2017\u20132020), which enrolled adults with acute spontaneous supratentorial ICH, randomized to receive levetiracetam or placebo. Patients underwent systematic 48\u2010h cEEG within 48\u2009h of symptom onset. Electrographic seizures and interictal EEG patterns were analyzed using standardized terminology of the American Clinical Neurophysiology Society. Associations between rhythmic and periodic patterns (RPPs) and seizures with clinical and radiological variables were assessed using univariate analyses. We also conducted exploratory testing of the CAV (cortical involvement, age\u2009&lt;\u200965\u2009years, volume\u2009&gt;\u200910\u2009mL) score for predicting ASyS, incorporating RPPs and ASM exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010two patients were included (median [Q1\u2013Q3] age\u2009=\u200972 [60\u201379] years, 29% women), 19 in the levetiracetam group. Interictal EEG abnormalities were common and not influenced by ASM, including background asymmetry (73%), sporadic epileptiform discharges (62%), and RPPs (52%). RPPs were associated with ICH volume (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.039) and cortical involvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.003). Among patients with RPPs, 50% developed ASyS (20% in those treated with ASM vs. 75% in untreated patients,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.030). Most patients (91.7%) with seizures had RPPs that preceded seizures, in &gt;90% cases by 12 (Q1\u2013Q3\u2009=\u20094\u201325) h. Integrating RPPs into the CAV model led to an improvement of ASyS prediction (area under the curve\u2009=\u2009.949 vs. .918,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.53) that was statistically nonsignificant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>RPPs are strong markers of ictogenesis in acute ICH and precede ASyS, thus offering a potential therapeutic window. These findings support the use of early cEEG for risk stratification and personalized ASM prophylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.70017","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:41:57Z","timestamp":1763458917000},"page":"1433-1448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dynamics of early electroencephalographic patterns and epileptic seizures in acute intracerebral hemorrhage: A prospective controlled study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5813-176X","authenticated-orcid":false,"given":"Ziad","family":"Al\u2010Fatuhi\u2010Al\u2010Jundi","sequence":"first","affiliation":[{"name":"Department of Functional Neurology and Epileptology Neurological Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salom\u00e9","family":"Avenas","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Edouard Herriot Hospital Lyon University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3793-7126","authenticated-orcid":false,"given":"Pierre","family":"Tank\u00e9r\u00e9","sequence":"additional","affiliation":[{"name":"Center for Sleep Medicine Croix\u2010Rousse Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Philipeau","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology Fleyriat Hospital  Bourg en Bresse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Garnier","sequence":"additional","affiliation":[{"name":"Stroke Center, Department of Neurology Saint\u2010Etienne University Hospital  Saint\u2010Etienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7307-0809","authenticated-orcid":false,"given":"Laure","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology Unit, Department of Neurology Saint\u2010Etienne University Hospital  Saint\u2010Etienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0940-7224","authenticated-orcid":false,"given":"Nathalie","family":"Andre\u2010Obadia","sequence":"additional","affiliation":[{"name":"Department of Functional Neurology and Epileptology Neurological Hospital, University Hospital  Lyon France"},{"name":"Lyon Neuroscience Research Center, Centre National de la Rcherche Scientifique Unit\u00e9 Mixte de Recherche 5292, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1028  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8681-7369","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Boulogne","sequence":"additional","affiliation":[{"name":"Department of Functional Neurology and Epileptology Neurological Hospital, University Hospital  Lyon France"},{"name":"Lyon Neuroscience Research Center, Centre National de la Rcherche Scientifique Unit\u00e9 Mixte de Recherche 5292, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1028  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-8521","authenticated-orcid":false,"given":"H\u00e9l\u00e8ne","family":"Catenoix","sequence":"additional","affiliation":[{"name":"Department of Functional Neurology and Epileptology Neurological Hospital, University Hospital  Lyon France"},{"name":"Lyon Neuroscience Research Center, Centre National de la Rcherche Scientifique Unit\u00e9 Mixte de Recherche 5292, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1028  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4663-8515","authenticated-orcid":false,"given":"Sylvain","family":"Rheims","sequence":"additional","affiliation":[{"name":"Department of Functional Neurology and Epileptology Neurological Hospital, University Hospital  Lyon France"},{"name":"Lyon Neuroscience Research Center, Centre National de la Rcherche Scientifique Unit\u00e9 Mixte de Recherche 5292, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1028  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8677-2447","authenticated-orcid":false,"given":"Tae\u2010Hee","family":"Cho","sequence":"additional","affiliation":[{"name":"Stroke Center Neurological Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Fontaine","sequence":"additional","affiliation":[{"name":"Stroke Center Neurological Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-5763","authenticated-orcid":false,"given":"Laura","family":"Mechtouff","sequence":"additional","affiliation":[{"name":"Stroke Center Neurological Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3990-9241","authenticated-orcid":false,"given":"Elodie","family":"Ong","sequence":"additional","affiliation":[{"name":"Stroke Center Neurological Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6725-7861","authenticated-orcid":false,"given":"Yves","family":"Berthezene","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Neurological Hospital, University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4274-0114","authenticated-orcid":false,"given":"Anne","family":"Termoz","sequence":"additional","affiliation":[{"name":"Public Health Unit, Clinical Research and Epidemiology Department Lyon University Hospital  Lyon France"},{"name":"Research on Health Care Performance RESHAPE, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1290, Universit\u00e9 Claude Bernard Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Perreton","sequence":"additional","affiliation":[{"name":"Public Health Unit, Clinical Research and Epidemiology Department Lyon University Hospital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9109-5604","authenticated-orcid":false,"given":"Julie","family":"Haesebaert","sequence":"additional","affiliation":[{"name":"Public Health Unit, Clinical Research and Epidemiology Department Lyon University Hospital  Lyon France"},{"name":"Research on Health Care Performance RESHAPE, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1290, Universit\u00e9 Claude Bernard Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1324-0356","authenticated-orcid":false,"given":"Muriel","family":"Rabilloud","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Edouard Herriot Hospital Lyon University Hospital  Lyon France"},{"name":"Biometry and Evolutionary Biology Laboratory, Centre National de la Rcherche Scientifique Unit\u00e9 Mixte de Recherche, Biostatistics Health Team  Villeurbanne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0909-8900","authenticated-orcid":false,"given":"Laurent","family":"Derex","sequence":"additional","affiliation":[{"name":"Stroke Center Neurological Hospital, University Hospital  Lyon France"},{"name":"Research on Health Care Performance RESHAPE, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1290, Universit\u00e9 Claude Bernard Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9938-9639","authenticated-orcid":false,"given":"Laure","family":"Peter\u2010Derex","sequence":"additional","affiliation":[{"name":"Center for Sleep Medicine Croix\u2010Rousse Hospital, University Hospital  Lyon France"},{"name":"Lyon Neuroscience Research Center, Centre National de la Rcherche Scientifique Unit\u00e9 Mixte de Recherche 5292, Insitut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale U1028  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70340-0"},{"key":"e_1_2_12_3_1","first-page":"708","article-title":"Intracerebral haemorrhage\u2014mechanisms, diagnosis and prospects for treatment and prevention nature reviews","volume":"20","author":"Seiffge DJ","year":"2024","journal-title":"Neurology"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.101180"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2019.01.013"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-306476"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2022.06.016"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987317705536"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31823648a6"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0013-9580.2004.38103.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873241247745"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.0465"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2024.107408"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18338"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000063316.47591.B4"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000281664.02615.6c"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00235-6"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.09.021"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.012410"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987320901391"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-012-9791-0"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2020.106286"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-024-02183-z"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182364878"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10439-3"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000538776"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01470-x"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.004686"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000125184.88797.62"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.08.014"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/aian.AIAN_154_18"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.4990"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.4656"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.5325"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000806"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004317"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-015-0391-0"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X17666181127124803"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.2015.1065180"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010054"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2005.11.030"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.19352"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452841"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2333"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873251340815"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000166"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200342"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.70039"},{"key":"e_1_2_12_49_1","first-page":"e1737","article-title":"Interrater reliability of expert electroencephalographers identifying seizures and rhythmic and periodic patterns in EEGs neurology","volume":"100","author":"Jing J","year":"2023","journal-title":"Neurology"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.70017","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/epi.70017","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.70017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T15:36:25Z","timestamp":1774280185000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.70017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/epi.70017"],"URL":"https:\/\/doi.org\/10.1111\/epi.70017","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]},"assertion":[{"value":"2025-07-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}