脑卒中后癫痫75例临床分析

Clinical analysis on 75 patients with epilepsy after cerebral stroke seizure

目的探讨脑卒中后癫痫的临床特点及发病机制。方法对1100例脑卒中患者中75例继发性癫痫患者的临床资料进行回顾性分析。结果脑卒中癫痫的总发生率为6.82%(75/1100),卒中后早期癫痫的发生率为53.33%(40/75),晚期发生率为46.67%(35/75),以部分发作为最多占64.0%(48/75),卒中后癫痫的发生率与病灶部位有关,皮质病灶较易发生卒中后癫痫,皮质(12.10%)与皮质下(2.98%)比较差异有显著意义(P<0.05),而不同卒中类型癫痫发生率差异无显著意义(P>0.05)。结论脑卒中是老年人癫痫发作的最常见原因,皮质病灶较易发生癫痫。

Objective To study the clinical characteristics and pathogenesis of post stroke secondary epilepsy.Methods The clinical data of 75 patients with acute symptomatic seizures and secondary epilepsy out of 1 100 post-stroke patients were retrospectively analyzed. Results The total occurrence rate of post-stroke acute symptomatic seizures and secondary epilepsy was 6.82% （75/1 100）.Early and late onset.rates post-stroke seizures were 53.33% （40/75） and 46.67%（35/75） respectively, of which partial onset seizures accounted for 64.0% （48/75）.The incidence of post-stroke epilepsy was related to the foci areas. Cortical infarcts were the risk factors for post- stroke late epilepsy. There was a significant difference between cortex and hypocortex （12.10% vs 2.98%, P 〈 0.05）, while there was no significant difference in the incidence of epilepsy among different types of strokes （ P 〉 0.05）. Conclusion Stroke is an important cause of acute symptomatic seizures and epilepsy in the elderly. Cortical infarcts are the risk factors for post-stroke late epilepsy. The incidence of early seizures is higher with cerebral ischemia, anoxia and hydrocephalus, while cortical infarcts are the risk factors for post-streke late epilepsy.