中风后癫痫59例分析

A Study on 59 Cases of Seizures after Stoke

对641例中风患者追踪观察1～3年,结果59例出现癫痫发作,中风后癫痫发生率为9.20％;脑出血与脑梗塞癫痫发生率间比较无已著差异(P>0.05);皮层损害者癫痫发生率显著高于皮层下损害者(P<0.01);脑出血继发癫痫发作多属早期发作(8/11),而脑梗塞多属迟发性癫痫发作(40/48)(P<0.01);早期癫痫发作需长期服抗癫痫药控制者显著低于迟发性癫痫发作(P<0.01)。提示:病损波及皮层是重要的致痫因素;早期发作与迟发性癫痫发作的发病机理不同,故表现出治疗与转归不同;迟发性癫痫尤其病灶波及皮层者长期规则服抗癫痫药是必要的。

We followed up 641 patients who had intracranial brain infarction(IBI) and intracranial cerebral hemorrhage (ICH), 59 of the 641 stroke patrents (9. 20%) had seizures. The occurrence was 11. 11% in ICH group, 8. 86% in IBI group, having no statistically significant differences between them ( P >0. 05). Incidence of seizures in patients with cortical lesions was significantly high compared with that in patients with subcortical lesions( P <0. 01). The early-onset seizures(8/11) were more than the late ones(3/11) in ICH group, but the late onset seizures(40/48) were more than the early ones(8/48) in IBI group ( P <0. 01). Patients who need anti-epileptic drugs in early-onset group were less than that of late-onset group ( P <0. 01). The results suggested that cortical lesion was an impomant risk factor to develop seizures. Mechanism between the early-onset seizures and the late-onset seizures were different, so the treatment and prognosis of them were different. It was necessary to take anti-epileptic-drugs regularly for patients wrth the late-onset seizure, cspecialy and with cortical lesions.