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1、脑卒中后癫痫临床特征及其预后研究【摘要】目的探讨脑卒中后继发癫痫的临床特征及其预后。方法对脑卒中后继发癫痫76例患者的发生率、发作时间、发作类型、与卒中类型及病灶部位的关系与预后等临床特征进行总结分析,同时随机抽取同期住院无癫痫发作的70例脑卒中患者(对照组),观察两组的临床疗效和神经功能缺损(NFD)评分变化。结果①脑卒中后癫痫发生率11.1%(76/682),其中早发性癫痫59.2%(45/76),迟发性癫痫40.8%(31/76);②皮层病灶继发癫痫60.5%(46/76),皮层下病灶继发癫痫39.5%(30/76),两者比较差异有统计学意义(P<0.01);③局限
2、性运动性发作40例(52.6%),其中早发性发作14例,迟发性发作26例;全身强直阵挛性发作31例和癫痫持续状态5例(47.4%)中,早发性发作26例,迟发性发作10例。⑷出血性卒中继发癫痫占61.8%(47/76),缺血性卒中占38.2%(29/76),两者比较差异有统计学意义(P<0.01);⑤癫痫组显著进步率明显低于对照组(P<0.01),癫痫组神经功能缺损评分均差于对照组(P<0.05)。结论脑卒中后癫痫皮层病灶多见,早发癫痫以全身发作为主,迟发癫痫以部分发作为主。脑卒中继发癫痫患者的治疗效果差于对照组,抗癫痫治疗有利于神经功能康复。【关键词】脑卒中;癫痫;临床特
3、征;预后10ClinicalfeaturesandprognosisanalysisofepilepsypatientsaftercerebralstrokeseizureHUANGWen-sheng.DeptarmentofNeurology,GuangxiBobaiPeople’sHospital,Bobai537600,China【Abstract】ObjectiveToexploretheclinicalfeaturesandprognosisofepilepsyfollowingcerebralstrokeseizure.MethodsTheclinicalfe
4、aturesof76patientswithepilepsyfollowingcerebralstrokeseizurewereanalyzedintheirincidence,seizuretime,types,stroketypesandlocation.70patientswithcerebralstroke(withoutepilepsy)wereselectedrandomlyascontrolgroup.Thetherapeuticeffectandneuralfunctiondefects(NFD)scoresofepilepsygroupandcontro
5、lgroupwereobserved.Results①Among682strokepatients,76casesdevelopedepilepsy(11.1%,76/682).45casesdevelopedseizuresinearlystage(59.2%,45/76),andtheothersinlatestage(40.8%,31/76).②46casesof76caseswithepilepsysufferedseizureswhichlocatedinbraincortex(60.5%,46/76),theotherswerelocatedinsub-cor
6、tex(39.5%,30/76).③40casespresentedwith10partialseizures(52.6%,14casesinearlystageand26inlatestage).31casespresentedwithgeneralizedtonic-clonicseizures(GTS)and5casessufferedepilepticstate(47.4%,26casesinearlystageand10casesinlatestage).④Thecasesofepilepsyfollowinghemorrhagicstrokeaccounted
7、for61.8%(47/76),theothersfollowingischemicstroke(38.2%,29/76)(P<0.01).⑤Thenotableimproverateofepilepsygroupwassignificantlylowerthanthatinthecontrolgroup(P<0.01).ThescoresofNFDintheepilepsygroupwerealllowerthanthoseinthecontrolgroup(P<0.05).ConclusionTheepilepsyfoll
