脑卒中后癫痫60例临床分析

Clinical analysis on 60 patients with epilepsy after cerebral stroke seizure

目的探讨脑卒中癫痫的临床特点及发病机制。方法对1000例脑卒中患者中60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6.00%,卒中后早期癫痫的发生率为53.33%(32/60),晚期发生率为46.67%(28/60),以部分发作为最多占65.00%(39/60),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(10.65%)与皮层下(2.73%)比较差异有显著性(P<0.05),而不同卒中类型癫痫发生率差异无显著性(P>0.05)。结论脑卒中是老年人癫痫发作的最常见原因,皮层病灶较易发生癫痫。

Objective To study the clinical charateristics and pathogenesis of secondary post stroke epilepsy. Methods The Clinical data of 60 patients with acute symptomatic seizures and secondary epilepsy out of 1000 post - stroke patients were retrospectively analyzed. Resetlts The total incidence rate of post stroke acute symptomatic seizures and secondary epilepsy was 6% （60/1 000）. Early and late onset rates of post - stroke seizures were 55.33 % （32/60） and 46.67 % （28/60） respectively, of which partial onset seizures were accounted for 65.00% （39/60）. The occurrence of post - stroke epilepsy was closely related to the locality of lesions. Cerebral cortical infarction was the risk factor for the occurrence of late post - stroke epilepsy. There was significant difference in incidence between lesions in cortex and subcortex （ 10.65% vs 2.73%, P 〈 0.05 ） while there was no significant cause for acute symptomatic seizures and epilepsy in elders. Conlusion The incidence of early seizure is higher in patients with cerebral ischemia, anoxia and hydrocephalus while cerebral cortical infarction is the risk factor for the occurrence of late post - stroke epilepsy.