脑梗死继发癫痫50例临床诊治分析  

Analysis of Clinical Diagnosis and Treatment of 50 Cases of Epilepsy Secondary to Cerebral Infarction

作　　者：张小寒 ZHANG Xiaohan(Department of Neurology,Panjin Liaoyou Baoshihua Hospital,Panjin 124010,China)

机构地区：[1]盘锦辽油宝石花医院神经内科,辽宁盘锦124010

出　　处：《中国医药指南》2020年第25期51-52,共2页Guide of China Medicine

摘　　要：目的分析脑梗死继发癫痫患者的临床诊断和治疗情况,以便为临床干预工作提供科学的依据。方法选择2018年5月至2019年1月来我院进行治疗的50例脑梗死继发癫痫患者作为调查对象,回顾性分析所有患者的临床资料,调查患者的梗死部位、癫痫发作时间和癫痫发作类型,评价对患者进行诊断的相关方法。对所有患者常规进行脑梗死的治疗和抗癫痫的治疗,部分癫痫发作患者应用卡马西平,全面癫痫发作患者应用丙戊酸钠,癫痫持续状态患者应用地西泮或苯巴比托。统计脑梗死继发癫痫的发生率、脑梗死继发癫痫患者中男女所占比例、早发性癫痫和迟发性癫痫所占比例、脑梗死的具体部位、患者的脑电图检查结果、预后情况;比较脑梗死继发癫痫患者治疗前后的格拉斯哥昏迷评分法(GCS)评分和Barthel指数评分。结果本研究同期收治脑梗死患者1259例,脑梗死继发癫痫的发生率为3.97%(50/1259);50例患者中,男性24例,女性26例;早发性癫痫患者31例(62.00%),迟发性癫痫患者19例(38.00%);梗死部位:位于额叶10例,颞叶20例,顶叶6例,顶枕叶2例,颞顶叶2例,基底节8例,小脑2例;脑电图检查结果显示:异常48例,正常2例;死亡患者1例,病死率为2.00%,此例患者为早发性癫痫患者,其余的早发性癫痫患者病情均得到好转,临床症状得以控制,迟发性癫痫患者均预后良好。所有患者治疗后的GCS评分和Barthel指数评分均优于治疗前,差异存在统计学意义(P<0.05)。结论脑梗死继发癫痫患者通过常规诊断可以确诊,故应强化对于该病症的治疗,对于早发性癫痫患者给予短期抗癫痫治疗,对于迟发性癫痫患者给予长期正规抗癫痫治疗,从而促进病症的缓解。Objective To analyze the clinical diagnosis and treatment of patients with epilepsy secondary to cerebral infarction,in order to provide a scientific basis for clinical intervention.Methods Selected 50 patients with epilepsy secondary to cerebral infarction who came to our hospital for treatment from May 2018 to January 2019 as the survey subjects,retrospectively analyzed the clinical data of all patients,and investigated the infarct location,seizure time and seizure type of the patients,evaluated relevant methods for diagnosing patients.Cerebral infarction and anti-epileptic treatment are routinely given to all patients,carbamazepine is used for some patients with seizures,sodium valproate is used for patients with general seizures,and diazepam or phenobarbital is used for patients with status epilepticus.Count the incidence of epilepsy secondary to cerebral infarction,the proportion of men and women in patients with epilepsy secondary to cerebral infarction,the proportion of early-onset epilepsy and late-onset epilepsy,the specific location of cerebral infarction,the results of Electroencephalogram examination of patients,and the prognosis situation;compared the Glasgow Coma Scale(GCS)score and Barthel Index score before and after treatment in patients with epilepsy secondary to cerebral infarction.Results In this study,1259 patients with cerebral infarction were treated during the same period.The incidence of epilepsy secondary to cerebral infarction was 3.97%(50/1259);Among the 50 patients,24 were males and 26 were females;31 patients(62.00%)with early-onset epilepsy,19 cases(38.00%)of late-onset epilepsy;infarct sites:10 cases in frontal lobe,20 cases in temporal lobe,6 cases in parietal lobe,2 cases in parieto-occipital lobe,2 cases in temporal and parietal lobe,and 8 cases in basal ganglia,2 cases of cerebellum.Electroencephalogram examination results showed that:48 cases were abnormal and 2 cases were normal;1 case died,with a fatality rate of 2.00%,this case was a patient with early-onset epilepsy,and th

关 键 词：脑梗死 癫痫 诊断 治疗 

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]