卒中后癫痫的临床特点及抗癫痫药物治疗情况分析

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英文篇名：Clinical Characteristics of Epilepsy after Stroke and Analysis of Antiepileptic Drug Treatment 作者：黄良升 ; 洪诸权 英文作者：HUANG Liang-sheng;HONG Zhu-quan;Department of Neurology, Nanqiao Hospital of Nan'an City;Department of Neurology, Quanzhou First Hospital; 关键词：卒中后癫痫 ; 临床特点 ; 抗癫痫药物 ; 治疗情况 英文关键词：Post-stroke epilepsy;;Clinical features;;Anti-epileptic drugs;;Treatment 中文刊名：HZZZ 英文刊名：China & Foreign Medical Treatment 机构：南安市南侨医院神经内科;泉州市第一医院神经内科; 出版日期：2019-02-01 出版单位：中外医疗 年：2019 期：v.38 语种：中文; 页：HZZZ201904019 页数：4 CN：04 ISSN：11-5625/R 分类号：62-65

摘要

目的探讨卒中后癫痫的临床特点及抗癫痫药物的治疗情况。方法方便选取该院2014年4月—2017年4月收治的80例卒中后癫痫的患者为研究对象,分为早发型癫痫组35例和晚发型癫痫组45例。对该组患者的临床特点及抗癫痫药物治疗情况。结果卒中后癫痫常见的病变部位为皮质(48例),显著高于皮质下(24例),差异有统计学意义(χ2=13.359,P=0.000)。迟发型癫痫在缺血性脑卒中患者的多于早发型癫痫(6例VS32例),早发型癫痫出血性脑卒中的例数多于迟发型癫痫(29例VS13例),差异有统计学意义(χ2=20.881,P=0.000)。早发型癫痫以部分性发作为主(19例),晚发型癫痫以全面强直阵挛发作为主(32例),两者的差异有统计学意义(χ2=6.051,P=0.010)。VEEG的痫样放电波检出率(84.4%)与REEG(64.0%)差异有统计学意义(χ2=3.742,P=0.045)。卒中后癫痫治疗上以单药治疗为主,早发型癫痫治疗后无发作率(47.5%)与晚发型癫痫(18.5%)的差异无统计学意义(χ2=1.766,P=0.184)。结论卒中后癫痫的不同类型临床特点不同,早发型癫痫治疗的效果要优于晚发型癫痫,应该给予积极的药物干预以减少复发的可能。
        Objective To investigate the clinical features of epilepsy after stroke and the treatment of antiepileptic drugs.Methods 80 patients with post-stroke epilepsy admitted to our department from April 2014 to April 2017 were conveniently enrolled. The patients were divided into 35 patients with early-onset epilepsy and 45 patients with late-onset epilepsy. The clinical characteristics of this group of patients and anti-epileptic drug treatment. Results The common lesions of epilepsy after stroke were cortex(48 cases), which was significantly higher than that of subcortical(24 cases). The difference was statistically significant(χ~2=13.359, P=0.000). Delayed-type epilepsy in patients with ischemic stroke more than early-onset epilepsy(6 cases vs 32 cases), the number of cases of early-onset epileptic hemorrhagic stroke was more than delayed-type epilepsy(29 cases of VS13 cases), the difference was statistically significant(χ~2=20.881, P=0.000). Early-onset epilepsy was mainly partial seizures(19 cases), and late-type epilepsy was dominated by generalized tonic-clonic seizures(32 cases).The difference was statistically significant(χ~2=6.051, P=0.010). The detection rate of epileptiform discharge wave(84.4%)and REEG(64.0%) of VEEG were statistically significant(χ~2=3.742, P=0.045). The treatment of epilepsy after stroke was mainly monotherapy. There was no significant difference between the rate of no seizures after early onset epilepsy(47.5%)and late onset epilepsy(18.5%)(χ~2=1.766, P=0.184). Conclusion Different types of clinical features of post-stroke epilepsy are different. The effect of early-onset epilepsy is better than that of late-type epilepsy. Active drug intervention should be given to reduce the possibility of recurrence.

引文

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