急性脑梗死病灶部位与痫性发作的相关性

Correlation between focus location of acute cerebral infarction and epileptic attack

目的探讨急性脑梗死患者的痫性发作症状与病灶部位的关系,为临床早期诊断和治疗提供依据。方法选择2020-07—2021-07鄂州市中医医院神经内科收治的急性脑梗死后继发痫性发作的患者97例为研究对象,讨论痫性发作的时间、类型、脑电图的特征和表现,与头部MRI结果中所示梗死部位之间的关系。结果早发型痫性发作发生率(63.92%)明显高于迟发型痫性发作发生率(36.08%),差异有统计学意义(P<0.05)。单纯部分性发作45例(46.39%),复杂部分性发作24例(24.74%),全面性发作24例(24.74%),不能分类发作4例(4.13%)。病灶在皮质区65例(63.77%),非皮质区32例(36.23%),差异有统计学意义(P<0.05)。97例急性脑梗死继发痫性发作患者发作期间视脑电图正常13例(13.40%),边缘状态脑电图改变6例(6.19%),视频脑电图异常患者78例(80.41%),其中视频脑电图异常以癫痫样放电为主。结论急性脑梗死后以早发型痫性发作多见。病灶在脑叶皮质者痫性发作发生率高。发作形式以部分性发作多见。急性脑梗死继发痫性发作患者中视频脑电图异常以癫痫样放电为主。

Objective To explore the relationship between the symptoms of scar attack and the location of focus in patients with acute cerebral infarction,so as to provide basis for early clinical diagnosis and treatment.Methods Totally 97 patients with secondary endoscopic attack after acute cerebral infarction treated in the De⁃partment of Neurology of Ezhou Hospital of traditional Chinese medicine from July 2020 to July 2021 were select⁃ed as the research object.The time,type,EEG characteristics and manifestations of similar attack and the relation⁃ship with the infarct location shown in the results of head MRI imaging were discussed.Results The incidence of early-onset seizures(63.92%)was significantly higher than that of degenerative seizures(36.08%)(P<0.05).There were 45 cases of simple partial seizures(46.39%),24 cases of complex partial seizures(24.74%),24 cases of comprehensive seizures(24.74%),and 4 cases of unclassified seizures(4.13%).The lesions were lo⁃cated in cortical area in 65 cases(63.77%)and non-cortical area in 32 cases(36.23%).The difference was sta⁃tistically significant(P<0.05).During the attack,visual EEG was normal in 13 cases(13.40%),EEG changes in marginal state in 6 cases(6.19%),and video EEG was abnormal in 78 cases(80.41%).Conclusion Early onset infatuation is common after acute cerebral infarction.The incidence of paroxysmal seizures was high in pa⁃tients with lesions in the lobar cortex.Partial seizures were common.Epileptic discharge was the main abnormality of video EEG in patients with epilepsy secondary to acute cerebral infarction.