| Objective：Cerebral vascular disease, patients will remain serious limb dysfunction, and somepatients also occur secondary to epilepsy, mental damage caused serious economic burden topatients and. Acute cerebral vascular disease early seizures after another attack, and wasdiagnosed with epilepsy probability significantly improve. Therefore, research is of greatsignificance to the disease occurrence, development, prognosis. The purpose of this study wasthe clinical data of acute cerebral vascular disease early epilepsy were analyzedretrospectively, so as to understand the disease mechanisms and characteristics, namely, theincidence of patients with gender, age, time of onset, seizure types, locations, hematomavolume relationship, and seizures were examined by EEG and TCD examination results, andtreatment and prognosis.Method：Retrospective analysis of2012December to2014January in Department of internalmedicine, nervous patients in our hospital in2348cases, including56cases of early epilepsypatients. For all the properties, location and variable selection of patients with disease, patientage and sex, and the seizure duration and type, EEG and TCD detection results of EEG, andthe patient treatment and outcome were statistical research.Result：1. Among the total of2348cases of patients with acute cerebral vascular disease, male,1341cases (57%), female1007cases (43%). Cerebral infarction in2066cases (88%),235cases of cerebral hemorrhage (10%),47cases of subarachnoid hemorrhage (2%). Earlyepileptic seizures in56patients,26were male (46%), female30cases (54%). Gender ofpatients compared with no statistical significance (P>0.05). Among them,26cases ofsecondary seizures after cerebral infarction (46%),25people attack after intracerebralhemorrhage (45%), subarachnoid hemorrhage episodes in5patients (9%). This group of earlyepileptic seizures occurred in2%. Different cerebral vascular disease early seizure incidenceof cerebral infarction in1%,10%cerebral hemorrhage, subarachnoid hemorrhage in12%. The results showed, subarachnoid hemorrhage, the incidence of male is slightly lower thanwomen, and subarachnoid hemorrhage seizure in male patients was significantly higher thanthat of female, there was significant correlation (P <0.05).2. In the cerebral infarction patients, aged50and50years old of the following earlyseizure occurrence rate is0.4%, and the disease incidence of50years old was1.4%, about3times of the former, and the results were statistically processed and the comparison of nostatistical significance (P>0.05). In addition, patients, cerebral hemorrhage and subarachnoidhemorrhage in patients50years of age more than50years the number of patients, butstatistically, no significant difference (P>0.05). This shows, cerebrovascular disease incidencerate along with the age of the population and a large increase in the proportion of patients,resulting in early seizures also increases with the growth of age.3. Time of onset: the incidence of cerebrovascular disease and epilepsy in5cases, theonset within l weeks of onset in29cases, L~2weeks onset of22cases.4. Seizure types: partial seizures in patients with the largest number,55cases (about98.2%), including simple partial seizure in28cases (50%), complex partial seizures in16cases (28.6%), partial seizure in11cases of secondary general seizures (about19.6%), only lpatients with status epilepticus (about1.8%).5. Location: early seizures after cerebral infarction,18patients with cortical infarction,accounted for69%(18/26), subcortical infarction accounted for31%(8/26), there wassignificant difference between them (P<0.01). Cerebral hemorrhage early epileptic seizuresin25patients, the cortex in19cases, accounted for76%(19/25), subcortical in6cases,accounting for24%(13/49), there are significant differences between them (P<0.01). Inshort, the early seizures cortical lesions accounted for64%, subcortical lesions accounted for36%, statistically compared statistically significant.6. The relationship between the volume of hematoma and seizures: early epilepticseizures in patients with bleeding amount is greater than35ml accounted for20%(5/25) ofcerebral hemorrhage, bleeding volume was less than35ml accounted for9.5%(20/210), thedifference was significant (P<0.05).7. EEG examination:31cases examined with electroencephalogram, results of the11cases of abnormal, accounted for36%, among them,3cases of mild to extensiveabnormalities (27%),5cases of EEG was moderately abnormal with limited alterations (46%),3cases of severe abnormal (27%). But in moderate and severe abnormal EEG,5cases can beseen from the limitations of the sharp wave, spike wave, sharp and slow wave, spike and slow wave complex or explosive of high amplitude slow wave rhythm, accounted for43%, whileothers are drug low amplitude fast rhythm accounted for66%.8. TCD examination: TCD examination in21cases, all patients with cerebral infarctionwere examined, the abnormal rate of blood flow velocity was63%(92/147),40cases in thecontrol group normal cerebral infarction patients abnormal rate was32%(89/280), there wasstatistical significance between two groups (P<0.01).9. Treatment and prognosis:45patients did not use of antiepileptic drugs, including40cases of1patients with1episodes,5episodes, a temporary intravenous injection ofdiazepam, poor control of intramuscular injection needle control symptoms when luminal.The remaining11patients received treatment with antiepileptic drugs, including taking C MasiBing in6cases (55%)，2cases (,18%), phenytoin sodium valproate in2cases (18%),1cases ofC Masi Bing joint phenobarbital treated patients (9%).10patients received singleconventional dose therapy,1patients with status epilepticus.Conclusion：1. Acute cerebral vascular disease early seizure occurrence rate is25%, among them,subarachnoid hemorrhage early seizure incidence rate was13%, the incidence rate of10%cerebral hemorrhage, and the incidence of cerebral infarction at least, only2%. In addition,the incidence of subarachnoid hemorrhage, women more than men, and subarachnoidhemorrhage seizures are male more than female.2. The incidence of early epileptic seizures and acute cerebral vascular disease have acertain relationship, i.e. when the onset of acute cerebral vascular disease, occurrence ofseizures will rate fast promotion, and at about L~stabilized at2weeks.3. Early epileptic seizure types more, and to part hair as the main type of attack, andepileptic seizure is the lowest. But the brain lesions in cortex subcortical attack the highest,lowest. The size of the lesions and the seizure of the incidence of certain relationship.4. TCD showed that the positive rate of early cerebral infarction and vascular stenosisdegree of seizure related, that there is a certain relationship between pathological mechanismof early epileptic seizures and brain tissue ischemia and hypoxia, as clinical data demonstratethe improved reference pathology mechanism.5.Seizures after acute cerebrovascular disease for the first time whether to antiepilepticdrug therapy, are still controversial, repeated attacks when the need for medication... |
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