Analysis On Associated Risk Factors Of Post-stroke Epilepsy

Background: Stroke,a common disorder in neurology,is a regular cause of epileptic seizures in middle-aged and old people.Post-stroke epilepsy(PSE)may aggravate the condition of the primary disease influencing its treatment and prognosis.Some studies have been conducted on PSE at home and abroad,however,the associated risk factors are uncertain and need to be determined.A retrospective study of PSE was conducted to find the related risk factors of PSE,providing some clinical data for predicting the occurrence of PSE.Objective: To study the clinical characteristics of PSE and its related risk factors after stroke.To explore the incidence,seizure type,time of the first outbreak,electroencephalogram(EEG)presentations and so on.Method: 1008 stroke patients hospitalized in the neurological department of our hospital form January 2014 to September 2015 were included in this study.All patient’s data were collected through outpatient visiting or telephone following up concerning gender,age,stroke types including cerebral infarction,intracerebral hemorrhage(ICH),subarachnoid hemorrhage(SAH),previous medical history including hypertension,diabetes,coronary heart disease,hyperlipidemia,complications including hyper-homocysteine hematic disease,pulmonary infection,bad habits including smoking,drinking alcohol,Lesions characteristics including lesion location and scope of lesions.And detailed records of patients diagnosed with post-stroke epilepsy the incidence,seizure type,the first time of outbreak,the electroencephalogram performance and so on.Univariate chi square test and multivariate Logistic regression analysis were used to study the related risk factors of PSE.1.The total incidence of PSE was 5.36%(54/1008),among which 4.54%(35/770)was PSE due to cerebral infarction,7.62%(16/210)was PSE due to intracerebral hemorrhage,10.71%(3/28)was PSE due to subarachnoid hemorrhage.Compared to that of cerebral infarction,the PSE incidence of cerebral hemorrhage had an increasing trend but no statistically significant difference was found(X~2 =3.16,P = 0.075).Results:2.Univariate analysis showed that:gender(X~2 = 4.117,P = 0.042),diabetes(X~2 = 4.89,P =0.027),pulmonary infection(X~2 = 8.95,P = 0.003),lesion location(X~2 = 45.139,P < 0.001)and scope of lesions(X~2 = 23.316,P < 0.001)were associated with seizures after stroke(P <0.05);Multivariate Logistic analysis showed that: gender(OR = 1.946,95%CI: 1.039~ 3.644),pulmonary infection(OR = 3.618,95%CI: 1.536~ 8.520),lesion location(OR = 6.435,95%CI:3.353~12.349)and scope of lesions(OR = 6.435,95%CI: 3.353~ 12.349)were more prone to seizures after stroke(P < 0.05).3.Early-onset epilepsy accounted for 63.11%(33/54)among which the predominant seizure type was simple partial seizure(SPS)in 36.36%(12/33).But only 38.89% were late-onset epilepsy and the seizure types were mainly generalized tonic-clonic seizure(GTCS)in42.86%(9/21)。4.EEG features in the intermittent period of epileptic seizures: 13.73%(7/51)had normal or critical state EEG,23.53%(12/51)diffuse slow wave on bilateral hemisphere,27.45%(14/51)focal slow waves ipsilateral to the focal lesions,15.69%(8/51)wide range of epileptic discharges on the bilateral hemisphere,19.61%(10/51)focal epileptic discharges ipsilateral to the lesion side.The results showed that the total detection rate of epileptic discharges was 35.29%(18/51).Conclusion:1.The incidences of PSE were variant in different types of stroke,the incidence of PSE after hemorrhagic stroke was higher than that than that of ischemic stroke.but there was no statistically significant difference.2.Males,pulmonary infection,lesion location in cortex and the larger scope of lesions may be the risk factors of PSE.3.PSE usually occured at 2 weeks after stroke and the predominant seizure type was simple partial seizure.Late-onset epilepsy was mainly composed of generalized tonic-clonic seizures.4.For most patients with PSE,EEG in the intermittent period of epileptic seizures showed non-specific slow wave and the detection rate of epileptic discharge was low.