自发性脑出血后继发癫痫的临床研究

来源 :湖南师范大学学报(医学版) | 被引量 : 0次 | 上传用户:danyuhong
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目的 :对自发性脑出血后继发癫痫的发作特点及治疗方法进行探讨。方法 :选取我院2010年1月~2015年1月收治的自发性脑出血后继发癫痫患者158例作为研究对象,对患者颅内出血部位与继发性癫痫的发作类型、发作时间之间的相关性、治疗方法等临床资料进行回顾性分析。结果 :158例脑出血继发癫痫患者中脑叶出血91例,其中58例为强直阵挛发作,33例为部分性发作,非脑叶出血67例,53例为部分性发作,14例为强直阵挛发作。脑叶出血中强直阵挛发作占63.7%,非脑叶出血强直阵挛发作占20.9%,两者比较有差异。另91例脑叶出血继发癫痫患者中早发型癫痫为58例,67例非脑叶出血继发癫痫的患者中早发型仅16例,两相比较有差异。对158例脑出血继发癫痫患者,均采用常规一线抗癫痫药物治疗,排除最终12例死亡患者,133例患者均无再发癫痫,有效率达91.1%。结论 :脑出血继发癫痫患者,脑叶出血多早发型,发作类型以强直阵挛发作常见,非脑叶出血多迟发型,发作类型以部分性发作常见。脑出血继发癫痫通过常规一线抗癫痫药物治疗有效。 Objective: To investigate the characteristics and treatment of secondary epilepsy after spontaneous intracerebral hemorrhage. Methods: A total of 158 patients with epilepsy secondary to spontaneous intracerebral hemorrhage admitted to our hospital from January 2010 to January 2015 were enrolled in this study. The correlations between intracranial hemorrhage sites and the type and duration of epilepsy were analyzed. Sex, treatment and other clinical data for retrospective analysis. Results: Of the 158 patients with cerebral hemorrhage, 91 were middle cerebral lobe hemorrhage with epilepsy, of which 58 were tonic-clonic seizures, 33 were partial seizures, 67 were non-lobar hemorrhage, 53 were partial seizures and 14 were Tonic clonic attack. Troponin episodes accounted for 63.7% of the patients with lobar hemorrhage and 20.9% of those with non-lobar hemorrhagic tonic. These two were quite different. Another 91 cases of epilepsy secondary to sequelae of cerebral hemorrhage were 58 cases of early-onset epilepsy, 67 cases of early-onset of epilepsy secondary to non-cerebral hemorrhage in only 16 cases, there are differences between the two groups. 158 patients with epilepsy secondary to cerebral hemorrhage were treated with routine first-line antiepileptic drugs, excluding the final 12 patients died, 133 patients without recurrent epilepsy, the effective rate was 91.1%. CONCLUSIONS: It is common in patients with epilepsy and cerebral lobar hemorrhage that intracerebral hemorrhage secondary to cerebral hemorrhage. Types of seizure are common in tonic-clonic seizures and non-sequelae with delayed onset. The types of seizures are common in partial seizures. Epilepsy secondary to cerebral hemorrhage through conventional first-line antiepileptic drugs effective.
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