缺血性脑卒中继发癫痫的影像学研究

目的：研究缺血性脑卒中后早发性癫痫和晚发性癫痫首次发作后再次发作的差异及其与梗死灶部位、大小的关系。方法：选择神经内科2006年9月—2010年1月首诊为缺血性脑卒中住院患者408例,随访时间1年。其中继发癫痫42例,分为早发性癫痫组（18例）和晚发性癫痫组（24例）。分析比较缺血性脑卒中后早晚期首次癫痫发作后再次发作的差异及其与梗死灶部位、大小的关系。结果：早发性癫痫和晚发性癫痫首次癫痫发作后再次发作的差异有显著性（P〈0.05）,皮质梗死是缺血性脑卒中继发癫痫的危险因素（P〈0.05）;梗死灶直径≥4 cm与〈4 cm分别发生早发性癫痫和晚发性癫痫的差异均无统计学意义（P〉0.05）。结论：缺血性脑卒中后晚发性癫痫更容易反复发作;缺血性脑卒中后癫痫的发作与影像学检查显示的梗死灶部位相关（累及皮质的梗死）,与影像学检查显示的梗死灶大小无关。

The iconography study of epilepsy after cerebral arterial thrombosis

Objective：To analyse the differences between the early-onset epilepsy and the late-onset epilepsy in patients after first and once again seizure and to investigate the relationship between it and infarction location and extent.Methods：Four hundreds and eight patients with first ischemic stroke in our hospital were reviewed from September 2006 to January 2010.These patients were followed up for one year.Among them,44 cpatients who developed post ischemic stroke epilepsy were devided into early-onset epilepsy group of 18 patients and late-onset epilepsy group of 24 patients.To analysis and compare the differences between the early-onset epilepsy and the late-onset epilepsy in patients after first and once again seizure and to investigate the relationship between it and infarction location and extent.Results：There was conspicuous difference between the early-onset epilepsy and the late-onset epilepsy in patients after first and once again seizure（P0.05）.Cortical infarction was a significant risk factor for the subsequent development of post ischemic stroke epilepsy（P0.05）.There was no significant difference and frequency between patients with infarction extent ≥4 cm in diameter and patients with infarction extent4 cm in diameter in epilepsy（P0.05）.Conclusion：Patients with post ischemic stroke in the late-onset epilepsy are easily seizured repeatedly.Post ischemic stroke epilepsy is associated with involving cortical infarction of imaging.There is no association between post ischemic stroke epilepsy and stroke extent of imaging.