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目的探讨急性脑卒中后继发癫痫的发生时间,发作类型,及其与病灶部位的关系、治疗措施以及预后问题。方法对50例脑卒中后继发癫痫患者的临床资料进行回顾性分析。结果继发性癫痫发生率5.75%,脑梗死21例(42.0%),脑出血23(46.0%),蛛网膜下腔出血6例(12.0%)。脑卒中后早期癫痫34例(68.0%),其中强直-阵挛发作22例,持续状态6例,部分性发作6例;迟发性癫痫16例(32.0%),其中强直-阵挛发作4例,部分性发作12例。皮层病灶36例,皮层下病灶14例。早期癫痫多不需长期抗癫痫治疗,迟发性癫痫多需长期抗癫痫治疗。结论脑卒中在急性期易继发癫痫,病灶在皮层区癫痫发生率高,早期癫痫以强直-阵挛发作发作多见,不需长期抗癫痫治疗,迟发性癫痫以部分性发作的多见,需长期抗癫痫治疗。
Objective To investigate the time of onset of epilepsy, the type of seizure, its relationship with lesion site, the treatment measures and the prognosis of acute stroke. Methods The clinical data of 50 patients with post-stroke secondary epilepsy were retrospectively analyzed. Results The incidence of secondary epilepsy was 5.75%, cerebral infarction in 21 cases (42.0%), cerebral hemorrhage in 23 cases (46.0%) and subarachnoid hemorrhage in 6 cases (12.0%). There were 34 cases (68.0%) of early epilepsy after stroke, including 22 cases of tonic-clonic seizures, 6 cases of persistent state, 6 cases of partial seizures, 16 cases of delayed epilepsy (32.0%), of which tonic-clonic seizure 4 Cases, partial seizures in 12 cases. 36 cases of cortical lesions, 14 cases of subcortical lesions. Early epilepsy and more long-term anti-epilepsy treatment, delayed epilepsy and more long-term anti-epileptic treatment. Conclusions Stroke is prone to epilepsy in acute stage, the incidence of epilepsy in cortex is high. Epilepsy is often seen in patients with tonic-clonic seizures. Long-term antiepileptic treatment is not needed, and partial seizures of delayed epilepsy are more common , Need long-term antiepileptic treatment.