卒中类型、卒中部位与卒中后癫痫的多因素关系

目的探讨卒中类型、卒中部位与卒中后癫痫的多因素关系,为卒中后癫痫的防治提供参考。方法以1804例卒中患者为研究对象,收集其性别、年龄、卒中类型、卒中部位、卒中后癫痫发生的时间等资料,根据卒中后是否发生癫痫,将患者分为卒中后无癫痫组(n=1487)和卒中后癫痫组(n=317),分析卒中后癫痫发作的危险因素。结果共317例卒中后癫痫发作患者,其中早发性癫痫141例(44.48%),迟发性癫痫176例(55.52%)。不同卒中部位及卒中类型的癫痫发病率为17.57%。多因素logistic回归分析显示,卒中部位中的顶叶合并蛛网膜下腔、额叶合并颞叶、额叶合并颞叶和枕叶、单一颞叶是卒中后发生癫痫的危险因素(P<0.01),其中单一颞叶是卒中后早发性癫痫的危险因素(P<0.01)。脑梗死患者常见早发性癫痫(23.66%),脑出血患者常见迟发性癫痫(47.95%)。结论卒中类型中的脑梗死、脑出血、蛛网膜下腔出血与卒中后癫痫有关;卒中部位中顶叶合并蛛网膜下腔、额叶合并颞叶、额叶合并颞叶和枕叶、单一颞叶与卒中后癫痫有关。

Multiple factors study of stroke type, stroke location and post-stroke epilepsy

Objective To explore the relationship between stroke type, stroke location and post-stroke epilepsy based on multiple factors analysis, so as to provide references for the treatment and prevention of post-stroke epilepsy.Methods A total of 1 804 stroke patients were selected as the research objects, and data including gender, age, stroke type, lesion location and onset time of post-stroke epilepsy were collected. Patients were divided into post stroke non-epilepsy group (n=1 487) and post-stroke epilepsy group (n=317) according to absence or presence of epilepsy onset after stroke, then the risk factors of post-stroke epilepsy were verified.Results Among the selected subjects, 317 patients had epilepsy after stroke, including 141 cases of early onset epilepsy (44.48%) and 176 cases of late onset epilepsy (55.52%). The incidence of each location and type of stroke was 17.57%. Multivariate logistic regression analysis showed that stroke lesions located in parietal lobe along with subarachnoid space, frontal lobe along with temporal lobe, frontal lobe along with temporal and occipital lobe, or temporal lobe were risk factors for epilepsy after stroke (P<0.01). Lesions located in temporal lobe was a risk factor for early onset epilepsy after stroke (P<0.01). Early onset epilepsy was common in patients with cerebral infarction (23.66%) and late onset epilepsy was common in patients with cerebral hemorrhage (47.95%).Conclusion Stroke types of cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage are related to epilepsy after stroke, moreover, the stroke locations are related to epilepsy after stroke include parietal lobe along with subarachnoid space, frontal lobe along with temporal lobe, frontal lobe along with temporal and occipital lobe, and temporal lobe.