Analysis Of Risk Factors For Early-onset Epileptic Seizures After Cerebral Infarction

Objective:Cerebral infarction is a disease with high morbidity,high disability rate,high mortality rate and high recurrence rate.With recombinant tissue plasminogen activator(rt-PA),acute intravascular intervention and standardized treatment of cerebrovascular diseases,the mortality of ischemic stroke is significantly reduced and more lives of patients with cerebral infarction are saved.Epilepsy is a common complication of ischemic stroke,and the incidence of epilepsy secondary to cerebral infarction is increasing year by year,which seriously affects the recovery,life quality and prognosis of patients.Repeated seizures involved patients into a wide range of neurophysiological and psychological problems,including paralysis,increased muscle tone,aphasia,dysarthria,unilateral neglect,numbness and pain,fatigue,cognitive impairment,depression and uncontrolled emotion.The economic burden of seizures caused by ischemic stroke is huge,so post stroke epilepsy(PSE)is an important problem faced by stroke survivors,which poses a challenge to clinical treatment.Further research is needed to explore the risk factors of epilepsy after cerebral infarction,which plays a certain guiding significance in predicting the onset of epilepsy after cerebral infarction and provides more meaningful information for clinical diagnosis and treatment,so as to provide patients with timely and effective clinical intervention,improve the prognosis of patients,improve their life quality.Methods:1.Research subjectsPatients with cerebral infarction treated in Qingdao central hospital from July 2017 to May 2019 were collected,which met the following criteria:(1)Patients who met the diagnostic criteria of cerebral infarction in "Neurology" and confirmed by imaging examination,as well as met the diagnostic criteria of epilepsy established by the International Union against Epilepsy;(2)They were all early seizures,that is,those who have seizures within two weeks after cerebral infarction and have no previous history of epilepsy;(3)They were not complicated with acute or chronic infection and no malignant tumor disease in a short period of time.Exclusion criteria:(1)Patients with severe immune system diseases,circulatory system diseases and heart,liver or kidney dysfunctions;(2)Patients with diabetes mellitus;(3)Patients with neurological disorders;(4)Patients with language disorders and hearing disorders that affect the research process;(5)Patients with epilepsy caused by craniocerebral surgery,brain trauma,brain tumors,etc.This study obtained the informed consent of the Ethics Committee of our hospital.2.Cases grouping50 patients with secondary epilepsy were selected as the observation group and 50 patients without secondary epilepsy as the control group.The course of disease was 1.41～10.02 months in the control group,with an average course of(5.45 ±1.33)months in the control group,and that in the observation group was 1.38～10.05 months,with an average course of(5.40 ±1.29)months.3.Data collectionThe clinical data of the two groups were collected.Including gender,age(<60 years old,≥60 years old),blood glucose(<11.1mmol/L,> 11.1mmol/L),electrolyte concentration(potassium,sodium,chlorine,calcium),infarct location(cortical and subcortical),infarction focus(single and multiple),cerebral infarction classification(cardiogenic and non-cardiogenic),NIHSS score(<15,≥15),serum homocysteine(Hcy),neuron-specific enolase(NSE)concentration and so on.4.Statistical methodSPSS 18.0 statistical software was used for analysis.The measurement data were expressed as mean±standard deviation(`χ±s),t-test was used and multivariate analysis of risk factors was analyzed by Logistic regression analysis.P<0.05 means the difference was statistically significant.Results:1.Analysis of general data of the two groups: there was no significant difference in gender,age,blood glucose and electrolyte concentrations between the two groups(P>0.05).2.The results of multivariate Logistic regression analysis showed that there were significant differences in infarction location,infarction focus,cerebral infarction classification and National Institute of Health Stroke Scale(NIHSS)score between the two groups(P<0.05).3.Comparison of serum Hcy and NSE concentrations between the two groups: the concentrations of serum Hcy and NSE in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:1.The infarction location of cortex,the classification of cerebral infarction of cardiogenic,the high NIHSS score and high concentrations of serum Hcy and NSE were the risk factors of secondary epilepsy in patients with cerebral infarction.2.The concentrations of serum Hcy and NSE in patients with epilepsy secondary to cerebral infarction will increase significantly.