42例缺血性卒中后癫痫发作危险因素探讨

目的:研究缺血性卒中患者继发早期癫痫发作和晚期癫痫发作的发病率、发作类型及缺血性卒中继发癫痫发作的临床危险因素。方法:分析山西省人民医院近3年来首发缺血性卒中的408例患者的年龄、性别、入院时意识、糖尿病、高血压、心源性疾病和卒中部位等的临床特征,随访6~12个月,其中缺血性卒中后继发癫痫发作患者42例,未继发癫痫发作患者366例。缺血性卒中后癫痫发作的患者依据癫痫发作的发生时间分为早期癫痫发作组(18例)和晚期癫痫发作组(24例)。分析缺血性卒中后早期癫痫发作和晚期癫痫发作的发病率、发作类型以及缺血性卒中后发生继发癫痫发作的临床危险因素。结果:缺血性卒中后癫痫发作的发病率为10.3%(42/408),其中早期癫痫发作的发病率为4.4%(18/408);晚期癫痫发作的发病率为5.9%(24/408)。早期癫痫发作的50.0%(9/18)为全面性强直-阵挛发作,晚期癫痫发作的58.3%(14/24)为单纯部分性发作。缺血性卒中后癫痫发作组与非癫痫发作组的临床特征经统计学比较,两组间心源性脑栓塞病例的发生率和累及皮质梗死的发生率比较差异有显著性(P<0.05)。结论:缺血性卒中后早期癫痫发作以全面性发作为主,晚期癫痫发作以单纯部分性发作为主;心源性脑栓塞和累及皮质梗死是缺血性卒中后癫痫发生的危险因素。

The retrospective analysis on 24 cases of epileptic seizure after cerebral retrospective

Objective:The purpose of this study was to analyse the incidence and the seizure subtype in early epileptic seizure and late epileptic seizure,to find out the clinical risk factors of patients who were ischemic stroke secondary epileptic seizure.Methods:We identified a cohort of 408 cases first ischemic stroke in latest 3 years.The patients were followed up for 6～12 months.There are 366 first ischemic stroke cases without secondary epileptic seizure;42 patients who developed post ischemic stroke epileptic seizure were devided into two groups,which were early epileptic seizure group with 18 patients and late epileptic seizure group group with 24 patients.The feature of patients′ age,gender,consciousness in hospital,diabetes,hypertension,cardioembolic disease and stroke location were collected.We analysed incidence,subtype of post ischemic epileptic seizure and clinical risk factors of ischemic stroke secondary epilepsy seizure.Results:The incidence of post ischemic stroke epileptic seizure was 10.3%(42/408).The early epileptic seizures took 4.4%(18/408) and the late epileptic seizures took 5.9%(24/408).There was a 50.0% rate of GTCS in patients with early epileptic seizures,while there was a 58.3% rate of simple partial seizure in patients with late epileptic seizures.To compare post ischemic stroke epilepsy group with no post ischemic stroke epilepsy group of the clinical feature,there was significant difference between the two groups of cardioembolic cerebral embolism rate and cortical infarction rate(P<0.05).Conclusion:Early epileptic seizure of post ischemic stroke is likely appeared to be GTCS.Late epileptic seizure is likely appeared to be simple partial seizures;cardioembolic ischemic stoke and cortical infarction are the risk factors of post ischemic stroke epilepsy.