| Objective:To investigate the clinical characteristics of poststroke seizures,to obtain some knowledge about the incidence,time of first outbreak,latency of seizures after stroke, seizure type,electroencephalogram(EEG),treatment and prognosis by collecting some information of 39 patients diagnosed poststroke seizure.Method:There were 461 patients admitted to Neurology Department of Qilu Hospital of Shandong University form July,2007 to September,2008 with established stroke.By retrospecting the information about stroke and seizures,we found 39 patients have poststroke seizures,including 25 men and 14 women with an average age of 62.69±2.58.Collect age,sex and type of stroke of all the patients and time of first outbreak, frequency of seizures,seizure type,history of stroke and other diseases,imaging information,electroencephalogram(EEG),treatments,effects and other clinical information of patients diagnosed poststroke seizure.Analyze the datas with statistical methods.Results:1.Seizures occurred in 39 patients of 461 patients with stroke(8.46%).There were no significant differences between men(8.12%) and women(9.15%),P＞0.05.There were no significant differences among different types of stroke,cerebral infarction(8.45%),cerebral hemorrhage(7.76%) and subarachnoid hemorrhage (50%),P＞0.05,Cortical lesions are at a significantly greater risk of seizures.P＜0.052.Among 39 patients of poststroke serzure,14 had early-onset(35.90%),of which 5 had serzure as first symptom,and the other 25(64.10%) had late-onset.There were significant differences in different types of stroke,P＜0.05.Cerebral infarction:6 early-onset(20.69%) and 23 late-onset(79.31%);cerebral hemorrhage: 7 early-onset(77.78%) and 2 late-onset(22.22%);subarachnoid hemorrhage had one early-onset.3.Among 39 patients of poststroke serzure,partial seizures(18) are the most common(46.15%),of which 17 were simple partial seizures(SPS) and 1 was complex partial seizure(CPS).There were 10(25.64%) generalized tonic-clonic seizures(GTCS) and 1(2.56%) status epilepticus.And the other 10(25.64%) were generalized tonic-clonic seizures converted from simple partial seizures(SPS→GTCS or SPS→CPS→GTCS).Different stroke types had significant differences(P＜0.05) in seizure types. Cerebral infarction had 16 SPS(55.17%),1 CPS(3.45%),4 GTCS(13.79%), 7 SPS→GTCS or SPS→CPS→GTCS(24.14%) and 1 status epilepticus(3.45%); cerebral hemorrhage had 1 SPS(11.11%),5 GTCS(55.56%) and 3 SPS→GTCS or SPS→CPS→GTCS(33.33%);subarachnoid hemorrhage had one GTCS.Latency of seizures after stroke had a significant effect(P＜0.05) on seizure type. Early on-set ones had 2 SPS(14.29%),8 GTCS(57.14%),3 SPS→GTCS or SPS→CPS→GTCS(21.43%) and 1 status epilepticus(7.14%).While late on-set ones had 15 SPS(60%),1 CPS(4%),2 GTCS(8%) and 7 SPS→GTCS or SPS→CPS→GTCS(28%).4.Only one patient had seizure when examining EEG.We got EEG results of intermission from the other 38 patients.Among these results,5 were normal (12.82%) and 34 abnormal(87.18%).As for the latter,8(20.51%) were slightly abnormal,with increased restricted slow waves or slowed a waves.24(61.54%) were moderate abnomal,with restricted slow waves in lesion area,mainly on the lesion side.7(17.95%) were significantly abnormal,with diffused slow waves, restricted eleptiform discharges,spike waves,sharp waves,spike-slow or sharp-slow complex waves.5.Two patients died with a mortality of 5.13%.One of them was status epilepticus with large-area infarctions,and the other was GTCS with large-area hemorrhage of several cerebral lobes.The other 38 patients of different seizure types could be controlled by correctly selected anti-epilepsy drugs,such as carbamazapine (CBZ),phenytoin(PHT),diazepam,gabapentin(GBP),lamotrigine(LTG).Conclusions:1.Incidence of poststroke seizures is 8.46%.There are no significant differences between different sexes or different stroke types.Cortical lesions have a significantly greater incidence than subcortical leisions.2.Late-onset is main type of poststroke seizures.Most early-onset ones are in the first 24 hours,some of which take seizure as the first symptom.Latency of poststroke seizures is significantly different in different stroke types.Late-onset is the main type of cerebral infarction,while early-onset is that of cerebral and subarachnoid hemorrhage.3.Simple partial seizure(SPS) is the most common type of poststroke seizures. Other common types are generalized tonic-clonic seizures(GTCS) and generalized tonic-clonic seizures converted from simple partial seizures(SPS→GTCS or SPS→CPS→GTCS).Seizure types are significantly different in different stroke types and latencies,maily SPS in cerebral infarction and GTCS in cerebral and subarachnoid hemorrhage;GTCS in early-onset ones and SPS in late-onset ones.4.Most patients of poststroke seizures have abnormal EEG results.Slight and significant abnormalities are uncommon.Main manifestations of slight ones are increased restricted slow waves or slowedαwaves,and that of significant ones are diffused slow waves,restricted eleptiform discharges,spike waves,sharp waves, spike-slow or sharp-slow complex waves.Moderate abnormalities are common,with restricted slow waves in lesion area,mainly on the lesion side.5.Only a minority of patients who have GTCS or status epilepticus with large areas of infarction or hemorrhage have a high mortality.Most patients can be controlled by long-term,regular and correct use of anti-epilepsy drugs,such as carbamazapine(CBZ),phenytoin(PHT),diazepam,gabapentin(GBP),lamotrigine (LTG).
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