脑卒中与癫痫发作的临床探讨

目的 探讨脑卒中与癫痫的发生率、临床特征和预后.方法 对489例确诊为脑卒中患者进行住院调查和出院后随访.结果 脑卒中后癫痫的发生率为12.96%;脑卒中后癫痫发作时间2周内发生率为50.79%,2周～2个月发生率为33.33%,2个月后发生率为15.87%;继发癫痫的各类型脑卒中,以脑出血最多（60.32%）,其次为脑梗塞（34.92%）,蛛网膜下腔出血最少（4.76%）;癫痫发作患者病灶主要位于脑皮质（44.44%）和脑叶（31.13%）.结论 脑卒中后癫痫发生与发病时间和病灶的部位（皮质和脑叶）密切相关（P〈0.01）.抗癫痫药和镇静药对脑卒中后癫痫发作的控制有较好的疗效（90.48%）.脑卒中后早期出现癫痫发作死亡率较高（9.52%）,提示要重视脑卒中早期治疗和及时抗癫痫治疗.

The Clinical Analysis of the Occurrence of Epilepsy in the Cases of Cerebral Apoplexy

Objective To explore the incidence of epilepsy in the cases of cerebral apoplexy, and to analyze the clinical features and prognosis. Method 489 cases of in-patients with cerebral apoplexy were investigated with follow-up visits. Results The incidence of epilepsy after the occurrence of cerebral apoplexy was 12.98%. The time of the occurrence of epilepsy within 2 weeks was 50.79%; between 2 weeks to 2 months was 33.33%; after 2 months was 15.87%. The types of cerebral apoplexy with secondary epilepsy were mainly cerebral hemorrhage(60.32%)and cerebral infarction(34.92%), and the less common type was the haemorrhage of the cavum subarachnoidale. The locations of the secondary epilepsy were mainly in the pallium(44.44%) and in the lobes of the brain(31.13%). Conclusions The occurrence of the epilepsy after the cerebral apoplexy are closely associated with the time and the locations (the pallium and the lobes of the brain) of the cerebral apoplexy(P < 0.01). Anti-epileptic and sedative medicines have good effect on preventing the secondary epilepsy after the cerebral apoplexy. The mortality is high (9.25%) in the case cerebral apoplexy followed with epilepsy in the early stage. Therefore it is important to treat cerebral apoplexy at early stage and promptly with anti-epileptic therapy.