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目的通过了解脑血管病即脑卒中后继发癫痫的特点,分析其临床关系。方法收集我院2004年至2008年脑卒中后继发癫痫42例,就其发作类型,卒中后癫痫发作时间与卒中类型、部位、范围的关系以及治疗、预后进行分析。结果脑卒中后继发癫痫以部分性发作为主,占69%;卒中后继发癫痫多在卒中早期(2个月内)出现,占52.4%;各种卒中继发癫痫的发生率分别为:脑出血5.7%,脑梗死7.9%,蛛网膜下腔出血6.2%;继发癫痫在脑叶卒中多见,共占76.1%:癫痫与卒中病灶的大小有关,脑梗死病灶直径2cm以上及脑出血量<10ml以上者分别占本组继发癫痫的83.3%和75%;卒中早期继发癫痫与迟发性癫痫的治疗、预后有明显区别。结论脑卒中继发癫痫以部分性发作类型多见,常于卒中早期发作,多发生于脑叶病变,与病灶大小有关。卒中早期继发癫痫不需长期服用抗痫药,迟发性癫痫需长期服用。
Objective To understand the characteristics of cerebrovascular disease, secondary epilepsy after stroke, and analyze its clinical relationship. Methods 42 cases of secondary epilepsy after stroke were collected from 2004 to 2008 in our hospital. The types of the seizure, the relationship between the epileptic seizure time after stroke and stroke type, location and range, as well as the treatment and prognosis were analyzed. Results Post-stroke epilepsy was mainly occurred in partial seizure, accounting for 69%. Post-stroke secondary epilepsy occurred mostly in the early stage of stroke (within 2 months), accounting for 52.4%. The incidence of secondary epilepsy after stroke was Bleeding 5.7%, cerebral infarction 7.9%, subarachnoid hemorrhage 6.2%; secondary epilepsy more common in cerebral lobes, a total of 76.1%: epilepsy and the size of the stroke lesions, cerebral infarction diameter of more than 2cm and cerebral hemorrhage <10ml or more accounted for 83.3% and 75% of the group of secondary epilepsy; stroke early epilepsy and delayed treatment of epilepsy, the prognosis were significantly different. Conclusions Stroke secondary epilepsy is more common in partial seizures and often occurs in the early stage of stroke. It occurs mostly in lobar lesions, which is related to the size of lesion. Epilepsy secondary to stroke does not require long-term use of antiepileptic drugs, delayed epilepsy need long-term use.