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目的:研究急性脑血管病后癫痫发作的发生率、发作时间及类型、有关因素及对预后的影响。方法:除外引起癫痫的其他脑部和代谢障碍疾病后,并除外短暂性脑缺血发作和多发性脑梗塞后,每例均经头部CT或MRI证实的急性脑血管病住院患者,随访其癫痫发作的情况。结果:本研究包括急性脑血管病患者1044例,癫痫发生率为5.36％(56/1044),各病种发生率分别为蛛网膜下腔出血19.35％(12/62),脑出血4.33％(19/440),脑梗塞4.61％(25/542)(其中脑栓塞9.09％,脑血栓形成3.99％,P<0.05)。82.1％的癫痫于发病内两周后发作。癫痫发作的类型蛛网膜下腔出血大部为全身性发作,脑出血和脑梗塞以部分性发作为主。除蛛网膜下腔出血外,癫痫发作与病变部位有关,脑血栓形成患者可能与病变大小有关。脑出血和脑梗塞合并癫痫一月内死亡率较未合并癫痫者死亡率高。结论:急性脑血管病继发癫痫发生率为5.36％,多数于病后两周内发生,发生率以蛛网膜下腔出血较高。癫痫发作与病变部位有关,累及皮层或邻近皮层者为多,可能与病变大小有关。合并癫痫的脑血管病患者急性期死亡率较高。
Objective: To study the incidence of epileptic seizures after acute cerebrovascular disease, the onset time and type, related factors and prognosis. METHODS: All patients with acute cerebrovascular disease confirmed by head CT or MRI after exclusion of other brain and metabolic disorders excluding epilepsy except transient ischemic attack and multiple cerebral infarction were followed up Epileptic seizures. Results: A total of 1044 patients with acute cerebrovascular disease were included in this study. The incidence of epilepsy was 5.36% (56/1044). The incidence of various diseases were 19.35% (12/62), 4.33% 19/440), cerebral infarction (4.61%, 25/542) (cerebral infarction 9.09%, cerebral thrombosis 3.99%, P <0.05). 82.1% of epilepsy attacks within two weeks after onset. Types of seizures Most of the subarachnoid hemorrhage systemic seizures, cerebral hemorrhage and cerebral infarction in part-based attacks. In addition to subarachnoid hemorrhage, epileptic seizures and lesion-related, cerebral thrombosis may be related to the size of the lesion. Intracerebral hemorrhage and cerebral infarction with epilepsy within one month mortality than those without epilepsy, high mortality. Conclusion: The incidence of secondary epilepsy in acute cerebrovascular disease is 5.36%, most of which occur within two weeks after the disease. The incidence rate is higher in subarachnoid hemorrhage. Epileptic seizures associated with the lesion, involving the cortex or adjacent cortex are more, may be related to the size of the lesion. Patients with epilepsy and cerebrovascular disease have a higher acute mortality rate.