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目的研究急性脑血管病(CVD)继发癫癎的发生率,发生时间、发作类型与病灶部位的关系,治疗措施以及预后。方法选择急性脑血管病经头部 CT 或(和)MRI(或)和腰椎穿刺确诊。结果本组急性脑血管病1271例,发生率为6.8%(86/1271),其中脑出血9.2%(28/305),脑梗死6.0%(54/896),蛛网膜下腔出血5.7%(4/70)。早发癫癎(2周内)发作80.2%(69/86),迟发癫癎(2周后发生)19.8%(17/86)。在脑血管病急性期继发癫癎的多不需长期抗癫癎治疗,而在恢复期和后遗症期继发癫癎的多需长期抗癫癎治疗。CVD 继发癫癎的死亡率明显增高(33.7%)。结论急性脑血管病继发癫癎的发生率6.8%。80.2%在2周内发生。脑出血继发癫癎多表现为大发作,脑梗死多表现为部分发作。脑血管病继发癫癎的死亡率明显增高。
Objective To study the incidence of epilepsy secondary to acute cerebrovascular disease (CVD), the time of onset, the relationship between the type of attack and the site of the lesion, the treatment and the prognosis. Methods Acute cerebrovascular disease was diagnosed by CT or MRI with or without lumbar puncture. Results The incidence of acute cerebrovascular disease in 1271 patients was 6.8% (86/1271), including 9.2% (28/305) for cerebral hemorrhage, 6.0% (54/896) for cerebral infarction, 5.7% for subarachnoid hemorrhage 4/70). Premature epilepsy (within 2 weeks) episode 80.2% (69/86), delayed epilepsy (2 weeks later) 19.8% (17/86). In the acute phase of cerebrovascular disease, epilepsy often does not require long-term antiepileptic treatment, while in the recovery and sequelae of secondary epilepsy need more long-term anti-epileptic treatment. CVD secondary epilepsy mortality was significantly higher (33.7%). Conclusions The incidence of secondary epilepsy in acute cerebrovascular disease is 6.8%. 80.2% happen within 2 weeks. Epilepsy secondary to cerebral hemorrhage and more performance for the major episodes of cerebral infarction and more partial seizures. Cerebral vascular disease secondary to epilepsy mortality was significantly higher.