[经典]脑卒中后癫痫的临床特征及其预后分析

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1、［经典］脑卒中后癫痫的临床特征及其预后分析脑卒中后癫痫的临床特征及其预后分析【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%

2、(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丁对照组(P〈0・05)。结论脑

3、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丁对照组，抗癫痫治疗有利丁•神经功能康复。【关键词】脑卒中;癫痫;临床特征;预后ClinicalfeaturesandprognosisanalysisofepilepsypatientsaftercerebralstrokeseizureHUANGWen-sheng.DeptarmentofNeurology,GuangxiBobaiPeople'sHospital,Bobai537600,China［Ab

4、stract】ObjectiveToexploretheclinicalfeaturesandprognosisofepilepsyfollowingcerebralstrokeseizure・MethodsTheclinicalfeaturesof76patientswithepilepsyfollowingcerebralstrokeseizurewereanalyzedintheirincidence,seizuretime,types,stroketypesandlocation.70patients

5、withcerebralstroke(withoutepilepsy)wereselectedrandomlyascontrolgroup・Thetherapeuticeffectandneuralfunctiondefects(NFD)scoresofepilepsygroupandcontrolgroupwereobserved.Results①Among682strokepatients,76casesdevelopedepilepsy(11.1%,76/682).45casesdevelopedsei

6、zuresinearlystage(59・2%,45/76),andtheothersinlatestage(40.8%,31/76)・②46casesof76caseswithepilepsysufferedseizureswhichlocatedinbraincortex(60.5%,46/76),theotherswerelocatedinsub-cortex(39・5%,30/76)・(§)40casespresentedwithpartialseizures(52.6%,14casesinearly

7、stageand26inlatestage)・31casespresentedwithgeneralizedtonic-clonicseizures(GTS)and5casessufferedepilepticstate(47.4%,26casesinearlystageand10casesinlatestage)・@Thecasesofepilepsyfollowinghemorrhagicstrokeaccountedfor61.8%(47/76),theothersfollowingischemicst

8、roke(38.2%,29/76)(P<0.01).⑤Thenotableimproverateofepilepsygroupwassignificantlylowerthanthatinthecontrolgroup(P<0.01).ThescoresofNFDintheepilepsygroupwerealllowerthanthoseinthecontrolgroup(P<0・05).Conc