脑卒中后癫痫的临床分析

目的探讨脑卒中后癫痫的临床表现、特点及发病机制和治疗原则。方法回顾分析近3年我院754例脑卒中患者中46例继发患者的卒中部位、癫痫发作特点、类型和治疗方法。结果脑卒中后癫痫发生率为6．1％（46／754），其中早发癫痫39例占5．2％（39／754），迟发癫痫7例占0．9％（7／754）；46例继发癫痫中，皮层病灶继发癫痫占78．2％（36／46），皮层下病灶继发癫痫占21．8％（10／46）。早发癫痫中全身发作30例，部分性发作9例；迟发癫痫中全身发作2例，部分性发作5例。皮层病灶继发癫痫较皮层下病灶继发癫痫多见，差异有显著性（P〈0．05）。并发癫痫患者预后较无癫痫患者差。结论腑卒中后癫痫皮层病灶多见，早发癫痫以全身发作为主，迟发癫痫以部分发作为主。早期控制癫痫发作有利患者康复。

A clinical analysis of epilepsy secondary to stroke

Objective To explore the clinical manifestations, features, pathogenesis, and treatment of epilepsy secondary to stroke. Methods The seizure location and features, types, and treatment of epileptic seizures were retrospectively analyzed in 46 storoke patients with epilepsy. Results The incidence of epilepsy secondary to stroke was 6.1% (46/754). 39 of 754 patients (5.2%) developed early-onset epilepsy and the remaining 7 (0.9%) occurred late-onset epilepsy. 78.2% (36/46) was cortex epilepsy and 21.8% (10/46) was posterior cortex epilepsy. In early-onset epilepsy, generalized tonic-clonic seizure occurred in 30 patients and partial seizure in 9; while in late-onset epilepsy, 2 patients presented with generalized seizure and 5 with partial seizure. Cortex epilepsy was more common than posterior cortex epilepsy (P＜0.05). The prognosis was worse in stroke patients with epilepsy than those without epilepsy.Conclusions Cortex epilepsy secondary to epilepsy is common. Early-oneset epilepsy mainly presents with generalized tonic-clonic seizure and late-onset epilepsy presents with partial seizure. Early control of seizures is beneficial for patient recovery.