卒中后早发性痫性发作28例临床病例特点分析
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摘要
目的探讨卒中后早发性痫性发作的发生率、临床特点、治疗及预后。方法回顾性分析2012年1月~2013年2月我院神经内科全部急性卒中住院的患者资料,对其中卒中后早发性痫性发作患者的临床资料进行总结。结果研究期间共有1973例住院急性卒中患者,其中有28例出现早发性痫性发作,发生率为1.4%;在脑梗死患者中发病率为1.1%(20/1785),脑出血患者中发病率为3.7%(8/188),两者差异具显著性(P<0.001);男性发病率为1.7%(20/1149),女性发病率为1.0%(8/824),性别差异无显著性。发作类型均为部分性或全面性强直-阵挛发作;病灶在脑皮质的13例(46.4%),皮质下6例(21.4%),皮质、皮质下均累及的9例(32.2%),皮质卒中更易引起卒中后早发性痫性发作,差异有显著性(P=0.01)。结论不同性别间发生卒中后早发性痫性发作无明显差异性,出血性卒中比缺血性卒中更易导致卒中后早发性痫性发作,皮质卒中比皮质下卒中更易引起卒中后早发性痫性发作。
Objective To discuss the incidence rate, clinic manifestation, therapy and prognosis of early seizures after stroke. Methods We reviewed and analyzed the patients at the Department of Neurology in our hospital that had stroke from Jan. 2012 to Feb. 2013. Results Among the 1973 stroke patients, 28 patients attacked by early seizures after stroke, the incidence rate was 1.4%. And the incidence rate was 1.1%(20/1785) when it came to the one who suffered infarction, 3.7%(8/188) as to the cerebral hemorrhage patients(P<0.001); among the 28 patients 20 were male, the incidence rate was 1.7%(20/1149), 8 were female, the incidence rate was 1.0%(8/824); the seizures types were partial seizure or generalized seizure after partial seizure. The number of the patients whose lesions located in cerebral cortex was 13(46.4%), 6(21.4%) patients' lesions located in subcortex, others'(32.2%) located in both cerebral cortex and subcortex. Conclusion The incidence of early seizures after stroke has no significant difference between different genders or the types of stroke, the cortical stroke could cause the early seizures after stroke more easily than subcortical stroke.
Objective To discuss the incidence rate, clinic manifestation, therapy and prognosis of early seizures after stroke. Methods We reviewed and analyzed the patients at the Department of Neurology in our hospital that had stroke from Jan. 2012 to Feb. 2013. Results Among the 1973 stroke patients, 28 patients attacked by early seizures after stroke, the incidence rate was 1.4%. And the incidence rate was 1.1%(20/1785) when it came to the one who suffered infarction, 3.7%(8/188) as to the cerebral hemorrhage patients(P<0.001); among the 28 patients 20 were male, the incidence rate was 1.7%(20/1149), 8 were female, the incidence rate was 1.0%(8/824); the seizures types were partial seizure or generalized seizure after partial seizure. The number of the patients whose lesions located in cerebral cortex was 13(46.4%), 6(21.4%) patients' lesions located in subcortex, others'(32.2%) located in both cerebral cortex and subcortex. Conclusion The incidence of early seizures after stroke has no significant difference between different genders or the types of stroke, the cortical stroke could cause the early seizures after stroke more easily than subcortical stroke.
引文
1 Jose M.Ferro and Francisco Pinto.Poststroke epilepsy[J].Drugs Aging,2004,21:639-653.
2中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29:379-380.
3吴逊,李文慧.国际抗癫痫联盟分类和名词委员会推荐的癫痫和癫痫综合征的分类(1989)[J].中华神经科杂志,2001,34:197-198.
4赖丰资.脑卒中后并发癫痫的研究进展[J].中国医药指南,2011,9:290-291.
5纪法进,刘冬玉.脑卒中后早发性癫痫与迟发性癫痫相关性研究[J].中国医疗前沿,2007,22:106-107.
6 De Herdt V,Dumoni F,Henon H,et al.Early seizures in intracerebral hemorrhage:incidence,associated factors and outcome[J].Neurology,2011,77:1794-1800.
7赵红东,陆敏,杨雪梅,等.卒中继发癫痫216例临床分析[J].脑与神经疾病杂志,2012,31:314-315.
8张晓琴,任善玲,陈顺仙.卒中后癫痫的临床与机理探讨(附148例报告)[J].中风与神经疾病杂志,1996,13:359-360.
9李江华.脑卒中后继发癫痫53例临床分析[J].中国社区医师,2011,36:156-157.
10王宪伟.脑卒中后早发癫痫62例临床分析[J].中国民康医学,2010,10:1229-1230.
11中华医学会神经病学分会脑血管病学组“卒中一级预防指”撰写组.中国卒中一级预防指南2010[J].中华神经科杂志,2011,44:282-288.
12 Goldstein LB,Bushnell CD,Adams RJ,et al.Guidelines for the primary prevention of stroke:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2011,42:517-584.
13曹传伟.脑卒中后癫痫研究进展[J].内科,2012,7:399-401.
14白嘎丽.299例卒中后癫痫的临床分析[J].内蒙古医学杂志,2012,45:228-230.
15于丹丹,杨世兵,赵性泉,等.卒中后癫痫发作时间分布及影响因素的研究[J].中国卒中杂志,2009,4:738-743.
2中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29:379-380.
3吴逊,李文慧.国际抗癫痫联盟分类和名词委员会推荐的癫痫和癫痫综合征的分类(1989)[J].中华神经科杂志,2001,34:197-198.
4赖丰资.脑卒中后并发癫痫的研究进展[J].中国医药指南,2011,9:290-291.
5纪法进,刘冬玉.脑卒中后早发性癫痫与迟发性癫痫相关性研究[J].中国医疗前沿,2007,22:106-107.
6 De Herdt V,Dumoni F,Henon H,et al.Early seizures in intracerebral hemorrhage:incidence,associated factors and outcome[J].Neurology,2011,77:1794-1800.
7赵红东,陆敏,杨雪梅,等.卒中继发癫痫216例临床分析[J].脑与神经疾病杂志,2012,31:314-315.
8张晓琴,任善玲,陈顺仙.卒中后癫痫的临床与机理探讨(附148例报告)[J].中风与神经疾病杂志,1996,13:359-360.
9李江华.脑卒中后继发癫痫53例临床分析[J].中国社区医师,2011,36:156-157.
10王宪伟.脑卒中后早发癫痫62例临床分析[J].中国民康医学,2010,10:1229-1230.
11中华医学会神经病学分会脑血管病学组“卒中一级预防指”撰写组.中国卒中一级预防指南2010[J].中华神经科杂志,2011,44:282-288.
12 Goldstein LB,Bushnell CD,Adams RJ,et al.Guidelines for the primary prevention of stroke:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2011,42:517-584.
13曹传伟.脑卒中后癫痫研究进展[J].内科,2012,7:399-401.
14白嘎丽.299例卒中后癫痫的临床分析[J].内蒙古医学杂志,2012,45:228-230.
15于丹丹,杨世兵,赵性泉,等.卒中后癫痫发作时间分布及影响因素的研究[J].中国卒中杂志,2009,4:738-743.