脑卒中后癫痫发作的临床特点和视频脑电图分析

Clinical and video electroencephalogram characteristics of patients with epileptic seizure following cerebral stroke

目的分析脑卒中后继发癫痫的临床和视频脑电图特征。方法对102例脑卒中后癫痫患者的临床特点和视频脑电图特征进行回顾分析。结果脑出血、蛛网膜下腔出血患者癫痫发生率明显高于脑梗死(69.4%vs79.6%vs 35.3%,P<0.05)。早发型癫痫为68.6%,其中蛛网膜下腔出血以部分性发作继发全面性发作多见。迟发型癫痫为31.4%,其中脑梗死占64.7%,部分性发作占23.5%(P<0.05);病灶在脑叶皮质者癫痫的发生率为82.4%;102例患者出现脑电图特异性异常54例(52.9%)。结论脑卒中后以早发型癫痫多见,早发型癫痫以蛛网膜下腔出血多见,迟发型癫痫以脑梗死多见。病灶在脑叶皮质者癫痫发生率高。脑卒中后继发癫痫发作形式早期以部分性发作继发全面性发作多见,迟发型癫痫以部分性发作多见。脑电图出现周期性一侧癫痫样放电预后差。

Objective To study the clinical and VEEG characteristics of patients with secondary ep- ilepsy following cerebral stroke. Methods Clinical and VEEG characteristics of 102 patients with secondary epilepsy following cerebral stroke were retrospectively analyzed. Results The incidence of epilepsy was significantly higher in patients with cerebral and subarachnoid hemorrhage than in those with cerebral infarction（69.4o//00 and 79.6% vs 35.3% ,P%O. 05）. The incidence of preco- cious epilepsy was 68.6% with its partial or general attack usually manifested as subarachnoid hemorrhage. The incidence of delayed epilepsy was 31.4% with cerebral infarction accounted for 64.7% and partial attack accounted for 23.5%（P〈0.05）. The incidence of epilepsy was 82.4% when the focus was located in cerebral lobule. Specific abnormalities were observed in 54（52.9%） of the 102 cerebral stroke patients. Conclusion Precocious epilepsy is commonly observed in pa- tients with secondary epilepsy following cerebral stroke and usually manifeated as subarachnoid hemorrhage. Delayed epilepsy is usually manifested as cerebral stroke. The indicidence of epilepsy is high when the focus is located in cerebral lobule. Early secondary epilepsy following cerebral stroke is usually manifested as partial or general attack and delayed epilepsy is usually manifested as partial attack. The prognosis of patients with secondary epilepsy following cerebral stroke is poor when the unilateral epilepsy-like discharge is found on VEEG.