缺血性卒中后癫痫发作和癫痫的相关因素研究

Risk factors of epilepsy after ischemic stroke

目的探讨缺血性卒中后癫痫发作的时间分布特点及癫痫发作及癫痫的危险因素。方法将643例首次发病的缺血性卒中患者分为癫痫发作组及无发作组,回顾性分析2组的临床资料和随访情况,进行单因素及多因素分析。结果缺血性卒中后癫痫发作发生率为7.93%（51/643）,癫痫的发生率为3.57%（23/643）,卒中后〈1周出现首次癫痫发作有20例（40.1%）,1-6月有19例（37.3%）;Logistic多因素回归分析显示皮质梗死及SSS评分〈30分是缺血性卒中患者癫痫发作的独立危险因素,迟发性癫痫发作是缺血性卒中后癫痫的危险因素。结论首次癫痫发作主要集中在缺血性卒中后〈1周及1-6月。SSS评分〈30分及皮质梗死的患者更容易出现癫痫发作,迟发性癫痫发作更容易出现癫痫反复发作。

Objective To explore the time distribution of seizures and the risk factors of epilepsy after ischemic stroke. Methods A total of 652 patients after first onset of ischemic stroke were enrolled in this 5-year retrospective study. The patients were divided into epileptic seizure group and seizure-free group. The risk factors for epileptic seizure were analyzed by univariate analysis and multivariate Logistic regression analysis. Results Epileptic seizures occurred in51 patients（ 7. 93%） in this study,and epilepsy occurred in 23 patients（ 3. 57%）. 20 cases（ 40. 1%） of seizures occurred within 7 days after acute stroke,19 cases occurring within one to six months. Multivariate Logistic regression analysis showed that SSS score 30 points and cortical infarction were independent risk factors for seizures after ischemic stroke,and lateonset seizure was a risk factor for epilepsy after ischemic stroke. Conclusions Seizures mainly occur in a week or within one to six months after ischemic stroke. The patients with SSS score 〈 30 points and cortical infarction are likely to develop seizures,and late-onset seizure are more prone to developing recurrent seizures.