卒中后癫痫的临床特点和抗癫痫药物治疗转归  

The Clinical Characteristics of Post-stroke Epilepsy and the Outcome of Antiepileptic Drugs

作　　者：上官亚菲[1] 张艳[1] 范玉兰 熊涛[1] 刘承灵 SHANGGUAN Ya-fei;ZHANG Yan;FAN Yu-lan;XIONG Tao;LIU Cheng-ling(Department of Neurology,Guiyang First People's Hospital,Guiyang,Guizhou Province,550002 China)

机构地区：[1]贵阳市第一人民医院神经内科,贵州贵阳550002

出　　处：《中外医疗》2020年第24期66-68,共3页China & Foreign Medical Treatment

摘　　要：目的探讨卒中后癫痫的临床特点和抗癫痫药物治疗转归。方法方便选取2016年1月—2019年10月在该院神经内科治疗的70例卒中后癫痫患者按照癫痫发作时间分为两组,观察组35例早发性癫痫患者(于脑卒中后2周内发作),对照组35例为晚发性癫痫患者(于脑卒中后>2周发作),分析两组的卒中部位、癫痫发作类型、脑电图、药物疗效。结果两组在皮质、皮质下、丘脑及其他部位的卒中发生率上差异无统计学意义(P>0.05);观察组以部分性发作为主,对照组以全面强直阵挛发作为主,两组发作类型差异有统计学意义(P<0.05);两组在VEEG异常波、痫样放电波检出率上差异无统计学意义(P>0.05),但观察组在REEG异常波、痫样放电波检出率低于对照组,差异有统计学意义(P<0.05);观察组治疗有效率为94.28%高于对照组的77.14%,差异有统计学意义(χ^2=4.200,P<0.05)。结论卒中后早发性和晚发性癫痫在发病部位上无明显差异,但在癫痫发作类型、脑电图上有一定差异,临床应进行规律用药治疗,避免诱因刺激,从而抑制癫痫再次发作。Objective To investigate the clinical characteristics of post-stroke epilepsy and the outcome of anti-epileptic drugs.Methods Seventy patients with post-stroke epilepsy treated in the Department of Neurology of the hospital from January 2016 to October 2019 were convenienty selected divided into two groups according to the time of their seizures.The observation group of 35 patients with early-onset epilepsy(within 2 weeks after stroke onset),35 patients in the control group were late-onset epilepsy patients(onset>2 weeks after stroke).The stroke location,seizure type,EEG,and drug efficacy of the two groups were analyzed.Results There was no statistically significant difference in the incidence of stroke in the cortex,hypocortex,thalamus and other parts between the two groups(P>0.05);the observation group had partial seizures,the control group had general tonic-clonic seizures,and the two groups had statistically significantly different seizures types(P<0.05);the two groups had no statistically significant difference in the detection rate of VEEG abnormal waves and epileptiform waves(P>0.05),but the detection rate of REEG abnormal waves and epileptiform waves in the observation group was lower than the control group,the difference was statistically significant(P<0.05);the treatment effective rate of the observation group was 94.28%higher than that of the control group 77.14%,the difference was statistically significant(χ~2=4.200,P<0.05).Conclusion There is no significant difference between early-onset and late-onset epilepsy after stroke,but there are some differences in the types of seizures and EEG.Clinical medications should be used regularly to avoid triggers and stimuli to prevent recurrence of epilepsy.

关 键 词：卒中后癫痫 临床特点 抗癫痫药物 治疗转归 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R743.3[医药卫生—临床医学]