| Objectives: Epilepsy was a common disease of nervous system,and stroke is the most common cause of epilepsy in older people. When epilepsy happened in elderly,there will be long-term impacts on their lives,families and our society. There are many studies found that if we give reasonable intervention and treatment to related factors,we will lower the recurrence rate and mortality rate of epilepsy after stroke.Methods: Our research was a retrospective study, the data came from the information from the hospital on October 2000 to December 2008 diagnosis on post-stroke epilepsy patients with a total of 160 cases. With the general collection of clinical data: including gender, age, past history, clinical manifestation,auxiliary examination and therapy. According to the stroke type of patients, the patients are divided into groups with cerebral infarction (CI) and cerebral hemorrhage (ICH). According to the time of first attack of post-stroke epilepsy,the patients are divided into early epilepsy (within 2 weeks post stroke) and late epilepsy (after 2 weeks post stroke). Between the various groups of patients, the clinical manifestation, treatment and recovery will be compared.Result:1,General information: 62.5% patients were male and others were female in 160 patients,age range from 20 to 89 years,and mean age was 62.34 year. Their past histories included stroke (134 cases), hypertension (96 cases), DM (28 cases), coronary heart disease (23 cases) and atrial fibrillation (7cases). Stroke subtype were divided into CI (121 cases) and ICH (39 cases).2,Onset time: In this group, the earliest seizure was happened at the same time as stroke happened and the latest seizure was happened 15 years after stroke. There were 36.88% patients with early epilepsy (within 2 weeks post stroke) which the most common seen at the same time stroke happened,and 63.12% patients with late epilepsy (after 2 weeks post stroke) that most common seen between 0.5 to 1.5 years after stroke. While early epilepsy were more common seen in young patients (ages<50 y) than elder patients (ages>50 y), (65.21%, 32.12%, P<0.05)3,Type of epilepsy attack: We found 50% of the patients had GTCS (80/160), 16.25% had simple partial seizures (26/160), 16.25% had complex partial seizures(26/160), 8.75% had GTCS secondary to partial seizures (13/160) and 8.75% had status epilepticus (14/160). In early epilepsy, 38.98% of the patients had GTCS, 47.46% had partial seizures and 13.56% had status epilepticus. While in late seizures, 56.44% of the patients had GTCS, 37.62% had partial seizures and 5.94% had status epilepticus. 4,Number and location of the lesion: There were 40 cases in our 160 cases study with only one lesion and 75% of them located in cortex (the order for more to less was temporal lobe, parietal lobe, frontal lobe, frontotemporal lobe, frontoparietal lobe, parieto-occipital lobe, temporo-occipital lobe, occipital lobe and temporoparietal lobe) and 27.5% of them located in subcortex including basal ganglia (15%) and infarction of big areas (10%). There were 120 cases with multiple lesions, 60.83% involved cortex (in order was temporal lobe, frontal lobe, temporoparietal lobe, occipital lobe, parietal lobe, frontotemporal lobe, frontoparietal lobe and parieto-occipital lobe) and 53.33% involved subcortex (basal ganglia area, cerebellum, thalamencephalon and brain stem)5,Auxiliary examination: 50.64% patients'WBC were higher than normal, and accounting for 67.31% neutrophilic granulocyte were higher than normal; 23 in 25 (92%) patients'(with diabetes mellitus) fasting serum glucose were higher than normal, and 40 in 103 patient'(without diabetes mellitus) fasting serum glucose were higher than normal. A few cases of patients'other auxiliary examinations (creatinine, blood urea nitrogen, blood sodium, blood potassium and blood calcium) were abnormal.6,EEG: 30 in 42 patients'EEG were abnormal, including sharp and spike wave (60%) andθ-wave and rhythm (40%), 73.33% (22/30) were recurrence. Others'EEG (12/42) were normal or borderline state, and 25% (3/12) were recurrence. After X2 test, P<0.05.7,Treatment: 87 in 160 (54.38%) patients were treated with anti-epileptic drugs(AEDs). There were 71.79% patients using AEDs in ICH, included first generation AEDs (carbamazepine, valproic acid and phenytoin) and new-generation AEDs (topiramate and oxcarbazepine), and there were 48.76% patients using AEDs in CI, 57 cases used only one drug, included first generation AEDs (carbamazepine, valproic acid) and new-generation AEDs (topiramate, lamotrigine and oxcarbazepine), while other two needed two drugs (carbamazepine and topiramate, phenytoin and valproic acid).8,Progress:The patients'improvement rate was 90% (ICH 89.74%, CI 90.08% ), and recurrence rate was 36.26%. The recurrence rate of early ICH was 36.36% (4/11), late ICH was 32.14% (9/28), early CI was 36.96% (17/46) and late CI was 34.21% (26/76).9,Complication: 41 in 160 patients (25.63%) have complications, including pneumonia (24/41), urinary tract infection (7/41), respiratory failure (2/41), stress ulcer (2/41), ketoacidosis (1/41), myocardial infarction (1/41), CI after epilepsy (2/41) and ICH after epilepsy (1/41). There are 28.07% patients (16/57) had complications in early epilepsy, and 14.04% (8/57) patients had bad progress. 24.27% patients (25/103) in late epilepsy had complications, and 3.88% (8/103) had bad progress. Mortality rate in patients with complications in early epilepsy were higher than that in late epilepsy (P<0.05).Conclusions: This study showed that the morbidity rate which patients'ages more than 50 years are higher than that ages less than 50 years, and as the ages increasing, the morbidity rate were much higher, male are more than female. Most patients have histories of stroke and other risk factors of cerebral vascular disease; Both ICH and CI were common seen late epilepsy, and early epilepsy was the most common seen at the same time stroke happened, late epilepsy was the most common seen between 0.5 to 1.5 years after stroke. Early epilepsy are more common seen in young patients (ages<50y), and late epilepsy are more common seen in elder patients (ages>50 y); Most patients in early epilepsy were partial seizures, and high frequency of GTCS in patients with late epilepsy, while status epilepticus were more common seen in early epilepsy; The lesions in cortex , big area and multiple lesions were all risk factors for epilepsy, and temporal lobe was most common seen in the lesion with lobe involvement; Most patients'EEG were abnormal and were more likely to recurrence than others; Nearly a half of the patients needed AEDs'therapy, and most of them only needed to use one drug; Status epilepticus were more likely happened in early epilepsy and often accompanied with complication. If the complications happened in early epilepsy, it will have a high mortality rate.
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