卒中后早发性痫性发作28例临床病例特点分析

目的 探讨卒中后早发性痫性发作的发生率、临床特点、治疗及预后。方法 回顾性分析2012年1月～2013年2月我院神经内科全部急性卒中住院的患者资料，对其中卒中后早发性痫性发作患者的临床资料进行总结。结果 研究期间共有1973例住院急性卒中患者，其中有28例出现早发性痫性发作，发生率为1.4%；在脑梗死患者中发病率为1.1%（20/1785），脑出血患者中发病率为3.7%（8/188），两者差异具显著性（P＜0.001）；男性发病率为1.7%（20/1149），女性发病率为1.0%（8/824），性别差异无显著性。发作类型均为部分性或全面性强直-阵挛发作；病灶在脑皮质的13例（46.4%），皮质下6例（21.4%），皮质、皮质下均累及的9例（32.2%），皮质卒中更易引起卒中后早发性痫性发作，差异有显著性（P=0.01）。结论 不同性别间发生卒中后早发性痫性发作无明显差异性，出血性卒中比缺血性卒中更易导致卒中后早发性痫性发作，皮质卒中比皮质下卒中更易引起卒中后早发性痫性发作。

Analysis of Twenty-eight Early Seizures after Stroke

Objective To discuss the incidence rate, clinic manifestation, therapy and prognosis of early seizures after stroke. Methods We reviewed and analyzed the patients at the Department of Neurology in our hospital that had stroke from Jan. 2012 to Feb. 2013. Results Among the 1973 stroke patients, 28 patients attacked by early seizures after stroke, the incidence rate was 1.4%. And the incidence rate was 1.1%（20/1785） when it came to the one who suffered infarction, 3.7%（8/188） as to the cerebral hemorrhage patients （P〈0.001）;among the 28 patients 20 were male, the incidence rate was 1.7%（20/1149）, 8 were female, the incidence rate was 1.0%（8/824）;the seizures types were partial seizure or generalized seizure after partial seizure. The number of the patients whose lesions located in cerebral cortex was 13 （46.4%）, 6 （21.4%） patients＇ lesions located in subcortex, others＇ （32.2%） located in both cerebral cortex and subcortex. Conclusion The incidence of early seizures after stroke has no significant difference between different genders or the types of stroke, the cortical stroke could cause the early seizures after stroke more easily than subcortical stroke.