脑卒中后癫痫发作的临床症状及脑电图分析  

Clinical symptoms and electroneurophysiological analysis of epileptic seizure after stroke

作　　者：李振科 王维峰 张赟 LI Zhenke;WANG Weifeng;ZHANG Yun(The Second People's Hospital of Jiaozuo City,Jiaozuo(454000),Henan China)

机构地区：[1]焦作市第二人民医院神经内科,河南焦作454000 [2]河南省中医药研究院内科 [3]河南中医药大学第一附属医院脑病科

出　　处：《癫痫与神经电生理学杂志》2020年第5期282-286,共5页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的:探讨脑卒中后癫痫发作的临床症状及神经电生理学特点。方法:回顾性研究2016年6月至2018年6月期间我院收治的546例脑卒中患者.经头颅CT或MRI检查,均符合脑卒中诊断标准,其中脑出血后继发癫痫患者36例、脑梗死后继发癫痫患者32例,蛛网膜下腔出血继发癫痫患者16例,合计脑卒中后继发癫病患者84例。分析癫痫发作的时间、癫痫分类和脑电图变化。结果:脑出血继发癫痫发作表现为早发型癫痫组显著高于迟发型癫痫组(x2=12.177,P=0.000);脑梗死继发癫痫发作表现为迟发型癫痫组显著高于早发性癫痫组(x2=16.242.P=0.000);部分发作型癫痫表现为迟发性癫痫组显著高于早发型癫痫组(x2=5.103,P=0.024);部分发作继发全面发作型癫痫的发生率表现为早发型癫痫组显著高于迟发型癫痈组(x2=5.103.p=0.024);与未发生癫痫的患者比较.癫痫发作患者的脑电图上界、下界、参考电极均显著高于对照组(t=31.342.P=0.010;t=29.038,P=0.011;t=32.945.P=0.010)。结论:脑卒中后癫痫发作与脑卒中的类型以及癫痫发作类型具有一定关联性.脑电图在临床上能够第一时间记录大脑放电及脑功能的变化情况,为临床诊治提供依据。Objective:To analyze the clinical symptoms and electroneurophysiological feathers of epileptic seizure after stroke.Method:A retrospective study was conducted on 546 patients with stroke in our hospital from June 1,2016 to June 1,2018.The results of transcranial CT or MRI were all in line with the diagnostic criteria of stroke,including 36 cases with epilepsy secondary to cerebral hemorrhage,32 cases with epilepsy secondary to cerebral infaretion,16 cases with epilepsy secondary to subarachnoid hemorrhage.a total of 84 cases with epilepsy alfter stroke.The seizure time,epilepsy classification.changes of video EEG were observed and analyzed.Result:The incidence of epilepsy secondary to cerebral hemorrhage was significantly higher in the early epilepsy group than in the late epilepsy group(x2=12.177.P=0.000).The incidence of epilepsy secondary to cerebral infarction was significantly higher in the late epilepsy group than in the early epilepsy group(x2=16.242),P=0.000.The incidence of partial seizure epilepsy was significantly higher in the late epilepsy group than in the early epilepsy group(x2=5.103,P=0.024).The incidence of partial seizure secondary com-prehensive seizure was significantly higher in the early epilepsy group than in the late epilepsy group(x2=5.103,P=0.024);compared with the patients without epilepsy,the upper bound,lower bound and reference electrode of epileptic patients were significantly higher than those of the control group(t=31.342,P=0.010;t=29.038,P=0.O1l;t=32.945,P=0.010).Conclusion:Epileptic seizure after stroke is somehow related to the types of stroke and epileptic seizure.Video EEG monitoring can detect and record the changes of brain discharge and brain function in the first place,and provide basis for clinical diagnosis and treatment.

关 键 词：脑卒中 癫痫 临床症状 脑电图学 

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