中风后癫痫59例分析

对641例中风患者追踪观察1～3年,结果59例出现癫痫发作,中风后癫痫发生率为9.20％;脑出血与脑梗塞癫痫发生率间比较无已著差异(P>0.05);皮层损害者癫痫发生率显著高于皮层下损害者(P<0.01);脑出血继发癫痫发作多属早期发作(8/11),而脑梗塞多属迟发性癫痫发作(40/48)(P<0.01);早期癫痫发作需长期服抗癫痫药控制者显著低于迟发性癫痫发作(P<0.01)。提示:病损波及皮层是重要的致痫因素;早期发作与迟发性癫痫发作的发病机理不同,故表现出治疗与转归不同;迟发性癫痫尤其病灶波及皮层者长期规则服抗癫痫药是必要的。

A Study on 59 Cases of Seizures after Stoke

We followed up 641 patients who had intracranial brain infarction(IBI) and intracranial cerebral hemorrhage (ICH), 59 of the 641 stroke patrents (9. 20%) had seizures. The occurrence was 11. 11% in ICH group, 8. 86% in IBI group, having no statistically significant differences between them ( P >0. 05). Incidence of seizures in patients with cortical lesions was significantly high compared with that in patients with subcortical lesions( P <0. 01). The early-onset seizures(8/11) were more than the late ones(3/11) in ICH group, but the late onset seizures(40/48) were more than the early ones(8/48) in IBI group ( P <0. 01). Patients who need anti-epileptic drugs in early-onset group were less than that of late-onset group ( P <0. 01). The results suggested that cortical lesion was an impomant risk factor to develop seizures. Mechanism between the early-onset seizures and the late-onset seizures were different, so the treatment and prognosis of them were different. It was necessary to take anti-epileptic-drugs regularly for patients wrth the late-onset seizure, cspecialy and with cortical lesions.