74例老年急性脑梗死继发癫痫患者的脑电图临床特点分析

The clinical characteristics analysis on 74 cases of elderly patients with acute cerebral infarction secondary epilepsy electroencephalogram

目的:探讨动态脑电图(EEG)在老年急性脑梗死继发癫痫患者诊断中的应用价值。方法:选取2015-01-2017-01期间我院收治的老年急性脑梗死患者148例,对患者脑梗死部位异常的脑电图类型进行观察和记录,分析患者脑电图异常与癫痫发作的关系。74例老年急性脑梗死后无癫痫患者作为对照组,74例老年急性脑梗死后继发癫痫患者作为研究组,对比两组患者的动态脑电图。结果:按照患者的癫痫发作位置不同,可以分为部分皮层发作44例,皮层下发作50例,分水岭18例,大面积梗死36例。其中癫痫异常放电分别为35、32、15、10例。不同发作位置癫痫异常放电的发生率分别为79.55%(35/44)、64.00%(32/50)、83.33%(15/18)、27.78%(10/36),4种不同位置癫痫异常放电发生率比较,差异均具有统计学意义。研究组患者AEEG异常概率为77.03%(57/74),脑叶皮质癫痫性疾病发生概率均高于深部白质,并且研究组患者神经功能的恢复时间明显长于对照组(P<0.05)。结论:EEG对于预测老年急性脑梗死继发癫痫疾病的发作以及病情变化具有重要的诊断价值,值得推广应用。

Objective：To study the dynamic electroencephalogram（EEG）in elderly patients with acute cerebral infarction secondary epilepsy diagnosis application value.Method：From January 2015 to January 2017 of our hospital 148 cases of elderly patients with acute cerebral infarction in patients with cerebral infarction site to observe and record the abnormal EEG type,analysis of EEG in patients with abnormal relations with seizures.Among them,74 cases of elderly patients with epilepsy after acute cerebral infarction as control group,74 cases of elderly patients with acute cerebral infarction secondary epilepsy after as a group,compared two groups of patients with dynamic EEG.Result：According to the patient＇s seizures position is different,can be divided into parts of the cortex attack44 cases,50 cases of subcortical attack,watershed in 18 patients,36 cases of large area infarction.The abnormal epileptic discharge 35,32,15,10 cases respectively.The incidence of abnormal epileptic discharge at different positions of attacks were 79.55%（35/44）,64.0%（32/50）,83.33%（15/18）,27.78%（10/36）,compare the incidence of abnormal discharge,four different location epilepsy differences are statistically significant.Team AEEG in patients with abnormal probability was 77.03%（57/74）,cerebral cortex epileptic disease probability were higher than that of deep white matter,and the team the recovery of neural function in patients with time significantly longer than control group（P0.05）.Conclusion：EEG in predicting the onset of epileptic disease and illness change has important diagnostic value.