脑卒中继发癫（癎）的临床特征及危险因素分析

目的 探讨脑卒中继发癫（癎）的临床特点及发生癫（癎）的影响因素,为临床防治提供依据.方法 回顾性分析2010-06-2012-06本院收治的76例（病例组）脑卒中后继发癫（癎）的患者资料,同时随机抽取神经内科住院的76例（对照组）未继发癫（癎）的脑卒中患者资料,分析脑卒中后癫（癎）的临床特点和相关危险因素.结果 脑卒中继发癫（癎）发生率7.7%（76/986）,其中缺血性脑卒中82.9%,出血脑卒中17.1%;早发性癫（癎）25.0%,迟发性癫（癎）75.0%;皮质病灶继发癫（（癎））69.7%,皮质下病灶继发癫（（癎））30.3%.单因素分析显示,2组患者脑卒中类型、病灶部位与受累半球侧别等因素比较,差异均有统计学意义（P〈0.05）;多因素分析显示,出血性脑卒中和皮质病灶差异有统计学意义（P〈0.05）.结论 脑卒中继发癫（癎）以迟发性癫（癎）多见.出血性脑卒中和皮质病灶是脑卒中继发癫（癎）的独立危险因素.

Analysis on clinical features and risk factors of epilepsy following cerebral stroke

Objective To analyze the pathogenesis,clinical features, treatment and risk factors of epilepsy following cere- bral stroke. Methods 76 Patients with epilesy after ischemie stroke and 76 ischemie stroke patients without epilepsy randomly treated in DaXin county Hospital from Jun. 2010 to Jun 2012 were reviewed. According to seizures they were divided into 2 groups： Epilepsy group and stroke group. The clinical data of the two groups were analyzed retrospectively by epidemiological method. Results Among the all stroke patients,7.7% developed epilepsy. Among them,82.9%was hemorrhagic stroke and 37. l%was chemic stroke. 25.0% developed seizures in early stage, 75.0% in late stage. 69, 7% suffered seizures located in brain cortex while 30.3% were located in sub-cortex. Univariate analysis showed that ischemie stroke type,affected location and affected hemisphere have significant difference between two groups. Multivariate logistic regression showed that ischemie stroke type and affected location were independent risk factors for post-isehemic stroke epilepsy. Conclusion Stroke is the main reason for epilepsy. In the case of epilepsy following cerebral stroke, late -onset epilepsy is more common. Lesions located in cerebral cortex and hemorrhagic stroke are the risk factors of the epilepsy following stroke seizure.