36例脑卒中后癫癎的临床分析

Clinical Research of Epilepsy After Stroke

目的探讨脑卒中后癫癎的临床特点及发病机制。方法对481例脑卒中病例中36例继发癫癎的临床资料进行回顾性分析。结果卒中后癫癎的发病率为7.48%,早期发作性癫癎为66.7%,迟发性癫癎为33.3%,发生率与病灶部位(皮层或皮层下)有统计学的差异。结论脑水肿、电解质紊乱、高血糖是早期癫癎的发作最重要的致病因素,迟发性癫癎是因胶质疤痕等因素形成的癫癎病状所致,对早期发作性癫癎应积极控制并发症,对迟发性癫癎进行正规抗癫癎治疗。

Objective To probe the clinical features and the onset mechanism of epilepsy after stroke. Methods The clinical data of 36 cases with secondary epilepsy from 481 cerebral apoplexies were studied retrospectively. Results The incidence of the epilepsy after stroke was 7.48% ,the epileptic attacking in early stage account for 66.7% and in late stage for 33.3%. The incidence of the epilepsy after stroke was quite different according to the location of focus （cortex/subcortex）. Conclusion The cerebral edema, electrolyte disturbance and hyperglycemia are important factors of the epileptic attack in early stage while the late epilepsy may be caused by the epileptic focus resulted from the glial scar. Strict and effective controlling complication should be taken in the early stage of epilepsy. The strict, systematic, and therapy should be taken in the last stage.