三大观察指标对脑梗死后亚临床型癫痫的诊断价值

Values of clinical diagnosis of three barometers to subclinical epilepsy after cerebral infarction

目的:评估脑梗死后病灶部位、脑电图、经颅多普勒等三大临床观察指标对亚临床型癫痫的诊断价值。方法:选取2007年1月～2009年12月我院符合国际脑梗死诊断标准(包括各种脑梗死类型)并在起病2周内出现痫样发作≥1次的60例患者为A组(致痫性脑梗死组),同期选取脑梗死后2周内未出现痫样发作的60例患者作为对照组B组(非致痫性脑梗死组)。全部病例既往均无癫痫病史。回顾性分析所有病例,对急性脑梗死病灶部位、脑电图表现、经颅多普勒结果等三大指标进行比较。结果:A组中皮质梗死(脑叶梗死)、经颅多普勒和脑电图结果异常明显高于B组,经统计学分析,差异均有统计学意义(均P<0.05),其中脑电图痫样放电或不典型异常波集中于A组。结论:脑梗死的病灶部位、经颅多普勒和脑电图表现可作为脑梗死后早发型癫痫的观察指标,对亚临床型癫痫有一定的诊断价值。

Objective：To evaluate the cerebral infarction lesion sites,EEG and transcranial Doppler as major indicators of clinical observation for diagnosis of subclinical epilepsy.Methods：From January 2007 to December 2009,60 cases of hospitalized patients with international diagnostic criteria of cerebral infarction（including of various types of cerebral infarction） and occurred epilepsy ≥ 1 time within 2 weeks were performed for group A（epileptogenic cerebral infarction group）.The other 60 patients in the same period within 2 weeks after cerebral infarction had not emerged epileptic seizures,which was group B of non-epileptic cerebral infarction group.All patients had no history of epilepsy.Cerebral infarction lesion site,EEG and transcranial Doppler in two groups were compared and analyzed for clinical diagnosis value of subclinical epilepsy diagnosis.Results：Cortical infarction（brain lobe infarction）,transcranial Doppler abnormalities and EEG abnormalities in group A were significantly higher than those of group B.The differences between two groups were statistically significant（all P〈0.05）,and the epileptiform or non-typical abnormal wave often occured in group A.Conclusion：Cerebral infarction lesion site,transcranial Doppler and EEG can act as barometers for early-onset epilepsy after cerebral infarction,which also have some diagnostic value of subclinical epilepsy.