摘要
目的探讨脑卒中后癫痫患者二次癫痫发作的危险因素分析及对抗癫痫药物治疗时机的研究总结。方法随访2016年5月至2018年9月本院及合作医院神经科门诊及住院患者185例,至少存在一次卒中后癫痫发作,98例发生二次癫痫发作患者为观察组,87例未发生二次癫痫发作患者为对照组,分析比较两组的临床特征。分析卒中后癫痫发作时间,根据早发性癫痫发作、晚发性癫痫发作,记为早发组和晚发组;记录第一次卒中后癫痫是否给予抗癫痫药物治疗,分为早发治疗组、早发未治疗组及晚发治疗组、晚发未治疗组。分析以上4组患者在连续随访时间点癫痫二次发作的发生率及好发时间。结果脑出血、病灶部位、脑电图、癫痫发作类型可能是与卒中后癫痫二次发作相关的因素;在3个月、6个月、9个月、12个月晚发组均较早发组癫痫再发率高,差异有统计学意义(P<0.05);晚发组6个月、9个月、12个月三个随访时间点的无发作率和总有效率差异有统计学意义(P<0.05)。晚发未治疗组较早发未治疗组的无发作率、总有效率低,晚发治疗组较未治疗组无发作率、总有效率高,在随访点差异均有统计学意义(P<0.05)。结论脑出血、病灶位于皮质、脑电图异常、晚发性癫痫可能是脑卒中后癫痫二次发作的危险因素;患者脑卒中后首次早发性癫痫发作不建议长期抗癫痫药物治疗,而晚发性则建议即开始长期治疗。
Objective To investigate the risk factors of secondary seizures in patients with post-stroke epilepsy(PSE)and to study the timing of anti-epileptic drugs treatment.Methods From May 2016 to September 2018,185 patients with at least one post-stroke seizure were enrolled in the neurology department and hospitalization of our hospital and cooperative hospital.Ninety-eight patients with secondary epilepsy were in the observation group,and eighty-seven patients without secondary epilepsy were in the control group.The clinical characteristics of the two groups were analyzed and compared.According to the seizure time after stroke,the patients were divided into early-onset seizure group and late-onset seizure group.Patients were divided into early-onset treatment group,early-onset untreated group,late-onset treatment group,and late-onset untreated group according to the treatment with or without anti-epileptic drugs.The incidence and onset of secondary seizures in different subgroups at different follow-up time points were analyzed.Results Cerebral hemorrhage,lesion site,EEG,and type of seizure may be factors associated with secondary seizures after stroke.At different time points(3m,6m,9m,12m),the incidence of epilepsy was higher in the late-onset group than in the early-onset group,the difference was statistically significant(P<0.05).There was a statistically significant difference in the rate of non-onset and total effective rate between the 6m,9m,and 12m follow-up points in the late-onset group(P<0.05).The rate of no seizures and total effective rate in the late-onset untreated group were lower than those in the early-onset untreated group,while the rates in the treatment group were higher than in the untreated group.Compared with the untreated group,the late-onset treatment group had no seizure rate and higher total effective rate,and the differences were statistically significant at the follow-up points(P<0.05).Conclusion Cerebral hemorrhage,lesions in the cortex,EEG abnormalities,and late-type epilepsy may be risk
出处
《浙江临床医学》
2020年第6期813-815,共3页
Zhejiang Clinical Medical Journal
基金
浙江省医药卫生科技计划项目(2019KY806)
关键词
卒中后癫痫
癫痫二次发作
危险因素
治疗时机
抗癫痫药物
Epilepsy after stroke
Secondary epilepsy seizures
Risk factors
Treatment of time
Antiepileptic drugs
