卒中后癫痫的临床特点及视频脑电图分析

Clinical Characteristics and Video Electroencephalogram Manifestation of Patients with Postapoplectic Epilepsy

目的:探讨卒中后癫痫患者的临床特点及视频脑电图特征。方法:对98例卒中后癫痫患者的临床资料和视频脑电图特征进行回顾性分析。结果:早发性癫痫多见于蛛网膜下腔出血和脑出血患者,发作类型以部分性发作继发全身性发作为主,占33.3%。迟发性癫痫多见于脑梗死患者,发作类型以简单部分性发作为主,占34.2%。脑叶区病灶较非脑叶区病灶卒中后癫痫发病率高。98例卒中后癫痫患者中脑电图异常者72例(73.5%),主要表现为癫痫样放电、局限性慢波活动等异常。结论:卒中后癫痫的发生与卒中类型、病程、病变部位有关,并有相应异常脑电图表现。行视频脑电图检查有助于指导治疗、评价预后。

Objective To explore the clinical characteristics and video electroencephalogram manifestations of patients with post-apoplectic epilepsy. Methods The clinical data and video EEG features of 98 patients with postapoplectic epilepsy were analyzed retrospectively. Results Early-onset epilepsy were mainly observed in patients with subarachnoid hemorrhage and cerebral hemorrhage,the typical seizures type of epilepsy was partial seizures following secondary generalized seizures,accounted for 33. 3%. Late-onset epilepsy were mainly observed in patients with cerebral infarction,the typical seizures type of epilepsy was simple partial seizures,accounted for 34. 2%. The incidence of post-apoplectic epilepsy in patients with cerebral lobe lesions was significantly higher than that of patients with non-lobe lesions. The abnormal EEG manifestation was observed in 72 cases,accounted for 73. 5%. The typical manifestation were epileptiform discharges and local slow-wave activity. Conclusion The occurence of post-apoplectic epilepsy could be related with the type,course and cerebral lesion area of stroke,which had the corresponding abnormal EEG. The video EEG is helpful to guide the treatment and prognosis evaluation in patients with post-apoplectic epilepsy.