脑梗死后早发性癫(癎)发作临床特点分析

目的:探讨脑梗死(CI)后早发性癫癎发作(EES)的临床特点。方法:对2643例确诊为CI患者的临床资料进行回顾性研究。结果:CI后EES的发生率为4.58%,女性高于男性(P<0.05);婴幼儿及未成年人高于成年人(P<0.01)和老年人(P<0.01);累及皮质的发生率高于未累及皮质的(P<0.01);EES作为CI首发症状者占49.59%,24h内出现者占76.03%,1周内出现者占94.21%,仅有5.79%在第2周出现;局灶性发作占65.29%,全面性发作占34.71%;给予AEDs治疗发作均可控制,伴有EES的患者病死率高于不伴有者(P<0.05)。结论:CI后EES较为常见,女性多于男性,未成年人的发生率高于成年人及老年人,与梗死部位有关,以局灶性发作为主,抗癫癎治疗有效,临床预后较差。

Retrospective Study of Early Epileptic Seizures After Cerebral Infarction

Aim:To explore the clinical features of early epileptic seizures(EES)after cerebral infarction(CI).Methods:To study retrospectively the clinical materials of 2 643 patients who have been diagnosed to have a CI.Results:The incidence of EES after CI is 4.58%;the incidence among the male,which is 3.83%,is lower than that among the female,which is 5.55%(P<0.05).The incidence among infants and juveniles is 30% and is obviously higher than that among the adults,which is 4.72%(P<0.01)and the group of the aged,which is 4.42%(P<0.01).The incidence of the adult group is slightly higher than that of the aged group(P>0.05).The incidence related to the cerebral cortex is 8.98% and shows distinct difference from the incidence unrelated to the cerebral cortex,which is 3.12%(P<0.01).The incidence of the disease focus on the left side is 4.25%,on the right side is 4.45% and on the both sides is 5.64% and there is no difference between any figures of two groups(P>0.05).Of the 121 cases,49.59% of the patients had EES as the initial symptom after CI,58.68% had EES within 6 hours after CI,76.03% within 24 hours,80.99% within 48 hours and 94.21% had within one week,and only 5.79% had in the second week;65.29% of the patients had partial seizures and 34.71% of the patients had generalized seizures.Medicines like diazepam,phenobarbital,carbamazepine,etc.are used to effectively prevent epileptic seizures from occurring.The death rate of patients with EES(14.88%)is higher than that of the patients without EES(9.16%)(P<0.05).Conclusion:EES after CI are quite common.The incidence among the female is higher than among the male,and the incidence among infants and juveniles is higher than that among the adult and the aged.EES are closely related to infarction parts,mainly are portion seizures and occur one week after CI.Antiepilepsy treatment is effective,and the prognosis is unfavourable.