早发性及迟发性急性缺血性卒中后癫痫的临床特点分析

Analysis on the clinical characteristics of early and late onset epilepsy af-ter acute ischemic stroke

目的探讨急性缺血性卒中后早发性及迟发性癫痫的临床特点。方法回顾性分析2012年6月~2016年6月福建省立医院神经科3108例急性缺血性脑卒中患者的临床资料,并长期随访(2~6年)。发生卒中后癫痫患者共108例,根据发作时间不同并分为早发性癫痫组(41例)及迟发性癫痫组(67例)。分析两组患者临床及影像学资料、癫痫发作分类及癫痫持续状态出现率、脑电图结果等。结果迟发性癫痫组男性比例高于早发性癫痫组(P<0.05);迟发性癫痫组平均年龄低于早发性癫痫组(P<0.05)。早发性癫痫组发作类型以单纯或复杂部分性发作为主,迟发性癫痫组发作类型以部分性继发全面性发作为主(P<0.05)。脑血管病危险因素、美国国立卫生研究院卒中量表评分、癫痫持续状态出现率、脑电图异常出现率、皮质受累比率、出血性脑梗死出现率等比较,差异均无统计学意义(P>0.05)。结论急性缺血性卒中后癫痫迟发患者较早发者更为年轻,男性更多;早发患者发作形式以单纯或复杂部分性发作居多,迟发患者以部分性继发全面性发作为主。

Objective To investigate the clinical characteristics of early and late onset epilepsy after acute ischemic stroke.Methods Clinical data of 3108 patients with acute ischemic stroke in the Department of Neurology of Fujian Provincial Hospital from June 2012 to June 2016 was retrospectively analyzed,with long-term follow-up (2-6 years).A total of 108 patients with epilepsy after stroke were divided into early-onset epilepsy group (41 cases) and late-onset epilepsy group (67 cases) depends on the time of attack.The clinical and imaging data,classification of seizures,occurrence rate of epileptic status and eeg results of the two groups were analyzed.Results The proportion of males in the late-onset epilepsy group was higher than that in the early-onset epilepsy group (P < 0.05).The mean age of later-onset epilepsy group was lower than that of early-onset epilepsy group (P < 0.05).The seizure types in the early onset epilepsy group were mainly simple or complex partial seizure,while those in the late onset epilepsy group were mainly partial secondary comprehensive seizure (P < 0.05).Cerebrovascular disease risk factors,National Institutes of health stroke scale score,occurrence rate of epileptic status,abnormal occurrence rate of electroencephalogram,cortical involvement rate,occurrence rate of hemorrhagic cerebral infarction,etc.were compared between the two groups,and the differences were not statistically significant (P > 0.05).Conclusion The patients with delayed epilepsy after acute ischemic stroke are younger and more male.The main attack form of early onset patients is simple or complex partial attacks,and the main attack form of late onset patients is partial secondary comprehensive attacks.