卒中后癫痫的临床特征和视频脑电图分析  

Clinical and vedio EEG analysis for patients of post-stroke epilepsy

作　　者：夏敏[1] 余佳佳 孔庆霞[1] XIA Min;YU Jiajia;KONG Qingxia(Department of Neurology,Affilated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院附属医院神经内科,济宁272000

出　　处：《癫痫杂志》2020年第5期410-415,共6页Journal of Epilepsy

基　　金：济宁市科技局资助项目(2014jn)。

摘　　要：目的探讨卒中后癫痫(Post-stroke epilepsy,PSE)患者的临床和视频脑电图(VEEG)特征。方法回顾性分析2015年1月—2018年6月济宁医学院附属医院收治的101例PSE患者,其中脑梗死后癫痫患者68例以及脑出血后癫痫患者33例,其中早发型癫痫5例,其余均为迟发型癫痫;女51例,男50例,女∶男=1.02∶1;发病年龄45~101岁,平均(68.10±10.26)岁。对所有患者的临床表现及VEEG资料进行回顾性分析。结果101例癫痫发作距离卒中的时间为(28.92±35.61)个月,≤1年60例(59.40%),1~5年26例(25.74%),5~10年15例(14.85%)。卒中后癫痫发作与性别无关(P>0.05);患者发病年龄60~75岁(62.38%)居多;卒中后1年内(59.4%)易出现癫痫发作;发作类型以局灶性发作(77.23%)为著;皮层梗死(77.94%)、合并脑动脉狭窄(83.82%)、合并高血压、糖尿病、心房颤动是梗死后癫痫的危险因素;发作间期EEG异常率为90.1%,表现为病灶侧慢波、病灶侧或病灶对侧癫痫波。结论卒中患者病变位置、病程时间长短、发病年龄、合并脑动脉狭窄程度均与癫痫的发生存在密切关系。VEEG对于诊断癫痫以及治疗和预后起重要作用。Objective To explore the clinical and video EEG features of patients with post-stroke epilepsy(PSE).Methods The clinical data of 68 patients with epilepsy after cerebral infarction and 33 patients with epilepsy after cerebral hemorrhage were analyzed retrospectively from January 2015 to June 2018 in the Affilated Hospital of Jining Medical University.There were 5 cases of early-onset epilepsy,and the rest were late-onset epilepsy.There were 68 cases of cerebral infarction(1 case showed post-infarction hemorrhagic transformation),33 cases of cerebral hemorrhage;51 females,50 males(f:m=1.02∶1);the onset age was 45~101 years,with an average of(68.10±10.26)years.Results The time from seizure to stroke in 101 cases was(28.92±35.61)months,60 cases(59.40%)≤1 year,26 cases(25.74%)1~5 years,and 15 cases(14.85%)5~10 years.Post-stroke epilepsy had no relation to gender(P>0.05).The age of onset is mostly in 60 to 75 years old(62.38%).Seizure often happen within 1 year after stroke(59.4%).The type of attack is focal seizure(77.23%).Cortical infarction(77.94%),cerebral artery stenosis(83.82%),hypertension,diabetes,and atrial fibrillation are risk factors for epilepsy after infarction.The abnormal rate of EEG for PSE is 90.1%,which was manifested as slow wave in the lesion side,epileptic wave in the lesion side or contralateral side.Conclusions The location,duration,age and severity of cerebral artery stenosis in patients with PSE are closely related to the occurrence of seizure.VEEG plays an important role in the diagnosis,treatment and prognosis of epilepsy.

关 键 词：卒中后癫痫 临床特征 视频脑电图 

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]