脑卒中后癫痫75例临床分析

目的探讨脑卒中后癫痫的临床特点及发病机制。方法对1100例脑卒中患者中75例继发性癫痫患者的临床资料进行回顾性分析。结果脑卒中癫痫的总发生率为6.82%(75/1100),卒中后早期癫痫的发生率为53.33%(40/75),晚期发生率为46.67%(35/75),以部分发作为最多占64.0%(48/75),卒中后癫痫的发生率与病灶部位有关,皮质病灶较易发生卒中后癫痫,皮质(12.10%)与皮质下(2.98%)比较差异有显著意义(P<0.05),而不同卒中类型癫痫发生率差异无显著意义(P>0.05)。结论脑卒中是老年人癫痫发作的最常见原因,皮质病灶较易发生癫痫。

Clinical analysis on 75 patients with epilepsy after cerebral stroke seizure

Objective To study the clinical characteristics and pathogenesis of post stroke secondary epilepsy.Methods The clinical data of 75 patients with acute symptomatic seizures and secondary epilepsy out of 1 100 post-stroke patients were retrospectively analyzed.Results The total occurrence rate of post-stroke acute symptomatic seizures and secondary epilepsy was 6.82% (75/1 100).Early and late onset rates post-stroke seizures were 53.33%(40/75) and 46.67%(35/75) respectively, of which partial onset seizures accounted for 64.0%(48/75).The incidence of post-stroke epilepsy was related to the foci areas. Cortical infarcts were the risk factors for post-stroke late epilepsy. There was a significant difference between cortex and hypocortex (12.10% vs 2.98%,P<0.05), while there was no significant difference in the incidence of epilepsy among different types of strokes (P>0.05).Conclusion Stroke is an important cause of acute symptomatic seizures and epilepsy in the elderly.Cortical infarcts are the risk factors for post-stroke late epilepsy. The incidence of early seizures is higher with cerebral ischemia,anoxia and hydrocephalus,while cortical infarcts are the risk factors for post-stroke late epilepsy.