摘要
背景:老年卒中后继发癫痫是老年人癫痫的主要原因,对卒中的康复和预后有一定的影响。目的:探讨卒中后癫痫发作与卒中类型、部位以及卒中面积的关系。设计:病例分析。单位:山东省千佛山医院神经内科。对象:选择1999-01/2004-12山东省千佛山医院神经内科住院的脑卒中后继发癫痫患者68例,男42例,女26例;年龄60～83岁,平均(68±7)岁。患者均知情同意。方法:①根据入组患者卒中后癫痫首发时间分为早发型癫痫(卒中后2周内发作);迟发性癫痫(卒中后2周后发作),分析癫痫发生时间与卒中类型的关系。②根据影像学结果将缺血性卒中(包括脑血栓形成和脑栓塞)按梗死面积分为:<一侧半球的1/4,1/4～1/2和>1/2;按脑出血量分为小于20mL,20～40mL和大于40mL。分析癫痫发作与卒中部位和面积的关系。③对患者进行对症治疗,并采用复诊形式进行随访6个月～4年,平均21个月。④计数资料差异比较采用χ2检验。结果:脑卒中后癫痫发作患者68例均进入结果分析。①癫痫发生时间与卒中类型的关系:早发性癫痫患者脑出血、蛛网膜下腔出血患者数明显多于迟发性癫痫患者(10,2例;4,0例,P<0.05),而脑血栓形成患者数明显少于迟发性癫痫患者(3,36例,P<0.05)。②癫痫发作与卒中部位和面积的关系:脑梗死面积占一侧半球的1/4～1/2和>1/2患者明显多于<一侧半球的1/4(26,17,9例,P<0.05);脑出血20～40和>40mL患者明显多于<20mL者(4,9,1例,P<0.05)。③癫痫发作的预后:21例早发性癫痫患者中,6例以癫痫为首发症状,15例患者2周内未再发作。47例迟发性癫痫患者中,18例1年后完全控制;23例癫痫控制良好;6例发作较频繁。结论:①早发性癫痫以脑出血、蛛网膜下腔出血和脑栓塞为主,迟发性癫痫以脑血栓形成为主。②脑梗死面积超过一侧半球面积的1/4,脑出血>40mL者发生癫痫的危险性明显增高。③早发性癫痫的预后�
BACKGROUND： Elderly post-stroke secondary epilepsy is the main cause of elderly epilepsy, and has a certain effect on the rehabilitation and prognosis of stroke. OBJECTIVE： To probe into the association of post-stroke epileptic attack with the type, location and size of stroke. DESIGN： A case analysis. SETTING： the Department of Neurology, Qianfoshan Hospital of Shandong Province. PARTICIPANTS： Between January 1999 and December 2004, 68 inpatients （42 males and 26 females） with post-stroke secondary epilepsy, aged 60-83 years with an average of （68±7）, were selected from the Department of Neurology, Qianfoshan Hospital of Shandong Province, and all the patients participated in the study voluntarily. METHODS： ① According to the time of the first attack of post-stroke epilepsy, the patients were divided into early epilepsy （within 2 weeks post stroke） and delayed epilepsy （after 2 weeks post stroke）, and the correlation between the time of epilepsy attack and types of stroke was analyzed. ② Based on the imaging results, the isehemie stroke （including cerebral thrombosis and cerebral embolism） was divided into groups of 〈 1/4, 1/4- 1/2, 〉1/2 of unilateral hemisphere according to the infarcted size, and di- vided into groups of 〈 20 mL, 20-40 mL, and 〉 40 mL according to the amount of cerebral hemorrhage, and the association of epileptic attack with the stroke location and size was analyzed. ③ All the patients received symptomatic treatment, and they were followed up for 6 months to 4 years with an average of 21 months by means of reexamination. ④ The differences of the enumeration data were compared with the x^2 test. RESULTS： All the 68 patients with post-stroke epileptic attack were involved in the analysis of results. ① The correlation between the time of epileptic attack and type of stroke： The eases of cerebral hemorrhage and subarachnoid hemorrhage were obviously more in the patients with early epilepsy than in those with delayed epilepsy （10, 2 cases; 4
出处
《中国临床康复》
CSCD
北大核心
2005年第37期156-157,共2页
Chinese Journal of Clinical Rehabilitation
