脑卒中后继发癫与性发作临床分析

Clinical analysis of postapolectic epilepsy and post-stroke seizure

目的总结和探讨脑卒中患者继发癫与性发作的发病率、病因、发病特点、诊断、治疗、预后及两者差异。方法回顾性分析我院近4 a来治疗的1 125例脑卒中患者的临床资料,对82例病例的发病时间、次数、脑电图情况及治疗、预后进行分析、研究。结果脑卒中患者继发癫及性发作的发病率为7.29%(82/1 125),累及皮层者发病率高。早期发作49例中36例仅发作1次,发作2次以上者9例,其中4例发生癫持续状态。迟发者33例中发作2次以上者有30例。40例行脑电图检查异常者仅12例。早期发作多为性发作,不需抗癫治疗,迟发者多为卒中后癫,需正规抗癫治疗。结论脑卒中后继发癫的发病率明显低于目前报道,许多诊断为癫者实际上仅是性发作,大多数卒中后癫及性发作预后较好,但癫持续状态预后差。

Objective To conclude and investigate the incidence rate,disease cause,disease character,diagnosis,treatment,prognosis and the difference between postapolectic epilepsy and post-stroke seizure.Methods Clinical data of 1125 stroke patients were retrospectively analyzed.Epilepsy occurred in 82 patients,the disease time,EEG,treatment and prognosis were analyzed,and the frequency was concluded.Results The incidence rate of symptomatic epilepsy and seizure in stroke patients was 7.29%,most of symptomatic epilepsy and seizure focus in cortex.Forty-nine epileptics happened in early time,of which 39 patients attacked only once and 9 epileptics attacked beyond twice and the other 4 patients attack status epilepticus.Thirty-three epileptics happened in later time,of which 3 patients attacked only once and 30 patients attacked beyond twice.Forty patients got the EEG examination,of which 12 patients was abnormal.The early attack was most seizure and they didn＇t need anti-epileptic treatment.The later attack was most postapolectic epilepsy and they needed regular anti-epileptic treatment.Conclusion The incidence rate of postapolectic epilepsy is lower than report;most of them are actually seizure.The postapolectic epilepsy patients and post-stroke seizure patients get better prognosis,but status epilepticus indicates worse prognosis.