脑梗死后继发性癫癇51例临床分析

Clinical analysis of secondary epilepsy after cerebral infarction in 51 patients

目的探讨脑梗死后继发癫癇的临床特点。方法回顾性分析51例脑梗死后癫癇患者的临床特点,比较癫癇发作时间、发作类型与脑梗死部位的关系。结果脑梗死患者皮质病变者38例(74.51%),皮质下病变者13例(25.49%);脑梗死后癫癇急性症状性发作22例(43.13%),其中继发全面性发作18例,部分性发作4例;迟发性癫癇29例(56.86%),其中继发全面发作14例,部分性发作15例;继发全面发作组病灶位于皮层处23例,皮层下9例;部分发作组病灶位于皮层处11例,皮层下8例,2组比较差异无统计学意义(P>0.05)。结论脑梗死后癫癇急性症状性发作以继发全面发作为主,迟发癫癇以部分发作为主;部分发作及继发全面发作均以皮层病变多见。

Objective To investigate the clinical characteristics of secondary epilepsy after cerebral infarction. Methods The clinical characteristics in 51 patients with secondary epilepsy after cerebral infarction were retrospectively analyzed, and the relationship of epileptic seizure time and type with the infarction site was investigated. Results In 51 patients of secondary epilepsy, there were cortical cerebral infarction in 38 patients （74.51%）, and subcortical cerebral infarction in 13 patients （25.49%）. And 22 patients （43.13%） suffered from early-onset epileptic seizure, in which 18 patients were secondary generalized seizure and 4 patients were partial seizure. In 29 patients （56. 86%） of late-onset epilepsy, secondary generalized seizure occurred in 14 and partial seizure occurred in 15. In the patients with secondary generalized seizure, lesions were located in cortex in 23 and in subcortex in 9. In patients with partial paroxysmal, lesions were located in cortex in 11 and in subcortex in 8. Lesions were mainly located in cortex in patients with both generalized and partial seizures, but there was no significant difference between two groups （P^0.05）. Conclusions The major type of early-onset epileptic seizure is secondary generalized seizure, and the late onset epileptic seizure is mainly presented by partial seizure. Both partial seizure and generalized seizure are predominately resulted from cortical cerebral infarction.