自发性脑出血后继发癫痫的临床研究

目的：对自发性脑出血后继发癫痫的发作特点及治疗方法进行探讨。方法：选取我院2010年1月～2015年1月收治的自发性脑出血后继发癫痫患者158例作为研究对象，对患者颅内出血部位与继发性癫痫的发作类型、发作时间之间的相关性、治疗方法等临床资料进行回顾性分析。结果：158例脑出血继发癫痫患者中脑叶出血91例，其中58例为强直阵挛发作，33例为部分性发作，非脑叶出血67例，53例为部分性发作，14例为强直阵挛发作。脑叶出血中强直阵挛发作占63.7%，非脑叶出血强直阵挛发作占20.9%，两者比较有差异。另91例脑叶出血继发癫痫患者中早发型癫痫为58例，67例非脑叶出血继发癫痫的患者中早发型仅16例，两相比较有差异。对158例脑出血继发癫痫患者，均采用常规一线抗癫痫药物治疗，排除最终12例死亡患者，133例患者均无再发癫痫，有效率达91.1%。结论：脑出血继发癫痫患者，脑叶出血多早发型，发作类型以强直阵挛发作常见，非脑叶出血多迟发型，发作类型以部分性发作常见。脑出血继发癫痫通过常规一线抗癫痫药物治疗有效。

Clinical Study of Secondary Epilepsy after Spontaneous Intracerebral Hemorrhage

Objective Clinical features and treatment of epilepsy after spontaneous intracerebral hemorrhage were analyzed and discussed. Methods Treated 158 patients with epilepsy after spontaneous intracerebral hemorrhage in our hospital from January 2010 to January 2015 are selected for the study. Intracranial bleeding site, secondary epilepsy seizure types, the cor-relation between times of seizure, treatment methods and other clinical data were analyzed retrospectively. Results show that in 158 cases of cerebral hemorrhage patients, 91 cases are epilepsy lobar hemorrhage including 58 cases of tonic-clonic seizures, 33 cases of partial seizures, 67 cases of non-lobar hemorrhage, 53 cases of partial seizures, and 14 cases of tonic-clonic sei-zures. Lobar hemorrhage tonic-clonic seizures accounted for 63.7% and non-lobar hemorrhage tonic-clonic seizures accounted for 20.9% respectively using the χ2 test and The difference was statistically significant. In another 91 cases of lobar hemorrhage patients, 58 cases are early-onset epilepsy while only 16 cases are early-onset lobar hemorrhage in 67 cases of non-epileptic patients. Comparing the two, the difference was statistically significant and For 158 cases of cerebral hemorrhage patients with epilepsy, antiepileptic drugs are used in a conventional first-line treatment. Excluding the final 12 deaths of patients, 133 pa-tients had no recurrence of seizures, and the effective rate is 91.1%. Conclusion In epilepsy patients with cerebral hemorrhage, lobar hemorrhage is commonly early onset and tonic-clonic seizures while non-lobar hemorrhage is commonly late-onset and partial seizures. The effect of conventional first-line antiepileptic drugs for cerebral hemorrhage epilepsy is good and it is worthy of promotion.