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大片脑梗死继发癫痫的临床观察及其对功能预后的影响 |
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许俭兴 燕铁斌 肖秀红
摘要 83例颈内动脉系统脑动脉硬化性大片脑梗死患者分为癫痫组(A组27例)和非癫痫组(B组56例)。癫痫发生率高达32.5%。临床观察表明：运动性癫痫是此类癫痫的主要发作形式(88.9%)。早发癫痫绝大部分(84.2%)演变成迟发癫痫，两者的发作形式也基本相同。与非癫痫组相比，癫痫组并发的肺部感染、急性心肌缺血和精神心理障碍明显增多(P＜0.05或0.01)，独立步行和日常生活自理能力亦明显下降(P＜0.05或0.005)。提示大片脑梗死继发的癫痫无论是早发还是迟发，在其首次发作后即应根据其发作类型开始正规抗癫痫治疗，以有利于预防癫痫再发和神经功能的恢复。
关键词 脑动脉硬化；脑梗死；癫痫；功能预后
Clinical Observation on Epilepsy Secondary to Large Cerebral Infarction and Its Outcome.
Xu Jianxin, Yan Tiehin, Xiao Xiuhong.
Department of Rehabilitation Medicine, Sun Yat-sen Memory Hospital, Sun Yat-sen University of Medical Science, Guangzhou 510120
Abstract Eighty-three patients with large cerebral infarction caused by cerebral arteriosclerosis within internal carotid artery were divided into two groups: 27 cases in the group with secondary epilepsy and 56 cases in the group without attack. The epileptic incidence was as high as 32.5 %. Results showed that motor epilepsy was the main attack. Majority of the early attack could be developed into delayed attack. Pulmonary infection, acute myocardial ischemia and psychologic problem in the group with secondary epilepsy were found more often (P＜0.05 or P＜0.01) than in the group without secondary epilepsy, meanwhile low ability in walking and ADL was also observed frequently in the same group (P＜0.05 or P＜0.005). It was suggested that regular antiepilepsy medication should be given as soon as the first epilepsy occurred in the large cerebral infarction whatever early or delayed epilepsy, which would be beneficial to both preventing epileptic reoccurrence or complication and promoting function recovery.
Key words cerebral arteriosclerosis; cerebral infarction; epilepsy; functional outcome
颈内动脉系统脑动脉硬化性大片脑梗死是住院常见的康复对象之一，其并发的继发癫痫发生率较高［1］。近6年来我们对此种癫痫发作的临床特点及其对功能预后的影响作了较为系统的临床观察。
1 资料与方法
1.1 资料与分组 1991年10月～1997年10月本科住院急性期和恢复期颈内动脉系统脑动脉硬化性大片脑梗死(直径＞3cm)患者共83例，分为①继发癫痫27例[1] [2] 下一页
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