脑血管病继发癫痫98例临床分析

Clinical analysis of 98 patients with symptomatic epilepsy secondary to cerebrovascular disease

目的探讨急性脑血管病继发癫痫的临床特点。方法对841例经颅脑CT证实的且无癫痫病史的急性脑血管病并发癫痫患者的发生率、发作类型、发作时间及临床疗效进行回顾分析。结果急性脑血管病继发癫痫发生率为11.65%(98/841),癫痫发作与病变部位有关,累及皮层或邻近皮层者易患发作类型以全身大发作占57.14%(56/98),发作时间半年内发病率为73.46%(72/98),本组98例患者中,除3例半年后复发外,其余病人未再出现癫痫发作。结论急性脑血管病是症状性癫痫发作的原因之一,多数于卒中后半年内发生,部分患者以癫痫为首发症状,发作类型以全身大发作为主,临床治疗效果满意。

Objective To explore the clinical character of symptomatic epilepsy secondary to acute cerebravascular disease. Methods The incidence ,way ,time and clinical therapeutic effects of symptomatic epilepsy secondary to acute cerebrovascular disease in 841 acute cerebrovascular disease patients with no epileptic history and confirmed by cranial CT scan were retrospectively analyzed. Results The incidence of secondary epilepsy following acute cerebrovascular disease was 11.65 % （98/841）. The epilepsy seizures were relevant to lesion site. The patients whose lesions of acute cerebmvascular disease located in or near cortex were more likely to suffer secondary epilepsy. The patients whose epilepsy seizures occurred in a half year after acute cerebrovascular attack accounted for 73.46% （ 72/ 98 ）. Among 98 patients in this study, reappearance of epilepsy seizures were found in 3 patients. Conclusion Acute cerebrovascular disease is a cause of symptomatic epilepsy. Most of patients mentioned above have secondary epilepsy seizures in a half year after acute cerebrovascular attack and epilepsy is the first symptom in some patients.