Clinical Analysis Of 48 Patients With Post-stroke Epilepsy

Background And Purpose: Post stroke epilepsy(PSE)is a common complication after cerebrovascular disease.There seems to be a growing research interest in PSE.This is perhaps part of general trend in the epilepsy field of increased focus on aetiology.PSE is different from other epilepsy types in gender,risk factors,pathophsyiology,management considerations and prognosis.More attention and researches of PSE should be considered.The aim of our study is to explore the clinical features,risk factors,auxiliary examination and treatment of PSE under the definition of acute symptomatic seizures and the definition of epilepsy from the International League Against Epilepsy(ILAE)in 2001 and 2014.Methods: A retrospective analysis was conducted from 48 patients hospitalized with neurological disease diagnosed as PSE in the Second Hospital of Jilin University from March 1,2014 to March 1,2017.According to the stroke types,the patients were divided into cerebral infarction group(CI)and intracranial hemorrhage group(ICH).According to the time of the first seizure after cerebrovascular disease,they were divided into early seizures(ES)group which the seizures occurred within 1 week after cerebrovascular disease and late seizure(LS)group which the seizures occurred more than 1 week after cerebrovascular disease.Much information such as general information,stroke types,onset time,onset types,lesion sites,severity of stroke(National Institute of Health stroke scale,NIHSS)and laboratory tests were collected.The diagnosis of seizure types was in accordance with the diagnostic criteria of seizure classification of the ILAE in 2001.The clinical characteristics,risk factors,auxiliary examination and treatment managements of patients with PSE were analyzed by t test and c2 test,(P <0.05 was statistically significant).Results: 1.Among the 48 patients,there were 37 subjects in cerebral infarction group,11subjects in cerebral hemorrhage group;24 subjects with ES and 24 subjects with LS.There was no significant difference in gender and age between the two stroke groups.22 patients had early seizures within 24 hours after stroke onset,while 11 patients developed later seizures in 6 months to 1 year after the diagnosis of stroke.2..Among the 48 patients,focal seizures occurred in 11 patients,generalized seizures occurred in 12 patients,epilepticus occurred in 25 patients.The seizure types were not associated with stroke types and seizure times(P1 = 0.410,P2 = 0.470).3.There were 31 cases of cortical lesion,17 cases of subcortical lesion,16 cases of single lesion,32 cases of multiple lesions.Regarding the intracerebral lesions,the difference of seizures was statistically significant in each group(P1 = 0.036,P2 = 0.038).4.Compared with ES group,the severity of stroke(NIHSS)of LE group was statistically significant(P = 0.024).5.There was no significant difference between the cerebral infarction group and the cerebral hemorrhage group in the results of the laboratory assay.Between the ES group and the LS group,triglyceride concentrations were statistically significant(P = 0.009).6.Most PSE patients had abnormal Electroencephalogram(EEG)results,manifested as slow waves,sharp waves,spike waves.7.Among the 48 patients,31 were treated with drugs,27 of them received monotherapy and seizures were well controlled.Conclusion: 1.The peak of ES occurred within 24 hours after cerebrovascular disease and the peak of LS occurred with 6-12 months after cerebrovascular disease.2.Cortical impairments,multiple lesions,stroke severity are the risk factors of PSE.3.That EEG appeared slow waves,sharp waves,spike waves is a risk factor of PSE,especially the sharp waves,spike waves.