脑卒中后症状性癫痫398例临床分析

Clinical Analysis of 398 Patients with Symptomatic Epilepsy After Stroke

【目的】探讨脑卒中后症状性癫痫的临床特点，为临床诊治提供指导依据。【方法】对5168例脑卒中患者中的398例症状性癫痫患者的临床资料进行回顾性分析。【结果】脑卒中后症状性癫痫的发生率为7．7％，其中早发型癫痫占59．3％，迟发型癫痫占40．7％；早发型癫痫以脑出血为多，占63．1％，发作类型以全面性发作为多；迟发型癫痫以脑梗死为多，占63．0％，发作类型以部分性发作为多；皮质区病灶较易发生症状性癫痫，皮质区与皮质下区症状性癫痫的发生率比较差异有统计学意义（P〈0．05），而不同脑卒中类型症状性癫痫的发生率差异无统计学意义（P〉0．05）。【结论】脑卒中后症状性癫痫以早发型为多．多见于脑出血，而迟发型癫痫多见于脑梗死；病灶位于皮质区者较易发生症状性癫痫；对于迟发型癫痫应给予正规抗癫痫药物治疗。

[Objective]To explore the clinical characteristics and the mechanism of symptomatic epilepsy after stroke. [Methods]The clinical data of 398 patients with symptomatic epilepsy among 5168 hospitalized patients with stroke were analyzed retrospectively. [Results] The incidence of symptomatic epilepsy after stroke was 7. 7%. Among them, the patients with early-onset epilepsy occupied 59.3;./00, while those with late-onset epilepsy occupied 40.7 %. Cerebral hemorrhage（63.1%） was commonly seen in early seizure mainly with overall seizure. Cerebral infarction（63.0 %） was commonly seen in late-onset epilepsy mainly with partial seizure. The lesions in cortical area were apt to have symptomatic epilepsy. There was significant difference in the incidence of symptomatic epilepsy between cortical area and subeortical area. However, there was no significant difference in the incidence of symptomatic epilepsy among different types of stroke（ P 〉0.05）. [Conclusion]Symptomatic epilepsy after stroke is mainly early-onset, and cerebral hemorrhage is commonly seen. Late-onset epilepsy is frequently seen in brain infarction. The lesion located on cortical area is apt to have symptomatic epilepsy. Late-onset epilepsy should receive regular antiepileptie therapy.