| Objective:To explore the clinical,imaging and electrophysiology features of post ischemic stroke epilepsy in order to deepen understanding of post ischemic stroke epilepsy,strengthen the early prevention,guide clinical treatment and improve prognosis.Methods:101 patients with epilepsy after ischemic stroke and 101 ischemic stroke patients without epilepsy randomly treated in Huanhu Hospital from May.2007 to Jan.2009 were reviewed.According to seizures they were divided into 2 groups: epilepsy group and stroke group. Recorded age,gender,past history,serum electrolyte,disease status, ischemic stroke subtype, affected lobar or basal ganglia, affected hemisphere,brain atrophy,white matter demyelination and neurological deficit scores. The risk factors of epilepsy after ischemic stroke were then analyzed. We analyzed the time of first attack and seizure types. And then we analyzed the relationship between age,gender and time of seizure onset, seizure types.We also analyzed the relationship between seizure types, time of seizure onset and location,subtype of stroke.At last,we analyzed prognosis,neurological rehabilitation and complications of both group and electroencephalogram findings of epilepsy group.Statistical analysis were performed with the SPSS statistical package 15.0.Results:1.Univariate analysis showed that ischemic stroke type, affected location, affected hemisphere and neurological deficit scores have difference statistically between two groups.Multivariate logistic regression showed that hemorrhagic infarction, cortical location,and Scandinavian Stroke Scale<30 were independent risk factors for post ischemic stroke epilepsy.2.In epilepsy group,there are 24 early-onset seizures cases(23.8%) and 77 late-onset seizures cases(76.2%).37 cases presented with partial seizure(36.6%) and 64 cases with secondary generalized seizures(63.4%).There were no difference statistically between age,gender and time of seizure onset, seizure types.The seizure type and hemorrhagic infarction between early-onset seizures and late-onset seizures have difference statistically. Hemorrhagic infarction between partial seizure and secondary generalized seizures have difference statistically.3. The treatment of ischemic stroke efficiency between epilepsy group and stroke group have difference statistically,which accounts 85.1% and 95.0% respectively. There were no difference statistically between different seizure types. Lung infection and psychological disorder between the two groups have difference statistically.4. There are 78 cortical location cases,which include 41(52.6%) frontal lobe infarction,and 23 subcortex location cases. Secondary generalized seizures and partial seizure between cortical and subcortex location cases have difference statistically.5.Anterior circulation involvement between the two groups have difference statistically, which accounts 89.1% and 78.2% respectively. There are 32 and 25 cases respectively with unilateral carotid artery stenosis or occlusion in both groups,which 9 and 15 of them have good collateral circulation respectively. Collateral circulation between the two groups have difference statistically.6.EEG of interictal stage in 84 patients,21 of them can be captured in epileptic-form diacharges which were consistent with lesion sites.Conclusion:1. Ischemic stroke patients who have hemorrhagic infarction, cortical location, Scandinavian Stroke Scale<30 are prone to develop epilepsy.2.The case of late-onset seizures in post ischemic stroke epilepsy are more than early-onset seizures.Seizure types are mainly secondary generalized seizures which are more common in early-onset seizures.3.The case of hemorrhagic infarction in early-onset seizures are more than late-onset seizures. Hemorrhagic infarction are more common in secondary generalized seizures.4. Not only the treatment of ischemic stroke efficiency in epilepsy group is poor,but also complications are large.5.Incidence of epilepsy after ischemic stroke is associated with locations of focus, which is more common in frontal lobe.The case of secondary generalized seizures in cortical location are more than subcortex location.6. Anterior circulation involvement are more common in epilepsy group.The collateral circulation in epilepsy group are worse than stroke group for whose unilateral carotid artery stenosis or occlusion.7.EEG diagnosis is an essential means of checking on post ischemic stroke epilepsy. In the epilepsy group,30.9% of patients can be captured in epileptic-form diacharges which were mainly seen in the cortical location. |
