De Reuck Jacques, Hemelsoet Dimitri, Van Maele Georges
Stroke Unit, Department of Neurology, Ghent University Hospital, Ghent, Belgium.
Clin Neurol Neurosurg. 2007 Jul;109(6):501-4. doi: 10.1016/j.clineuro.2007.04.001.
Seizures occur more frequently in patients with an intracerebral haematoma (ICH) than in those with a cerebral infarct. However, the risk factors for seizures in association with an ICH are less well known.
The characteristics of medically treated patients with spontaneous ICHs, who developed seizures, were retrospectively compared to those who did not.
Fourteen patients were admitted to the Stroke Unit during 2004-2006 for seizures related to an ICH. Their characteristics were compared to those of 51 patients admitted during 2002-2004 for an ICH without subsequent seizures.
Early-onset seizures, occurring within 48 h of stroke onset, were observed in six patients with ICH related epileptic spells (42.9%). Late-onset ones occurred in eight patients, on average 8 months after the ICH. A focal onset of the seizures was documented in 75.7% of cases. Status epilepticus was observed in 21.4% of the patients. The seizures recurred in only 28.6% of the patients. Lobar haematomas were present in 78.6% of the seizure group, compared to 21.4% in the control group (P=0.008). In the former group a frontal lobe involvement was present in 57.1% compared to 9.8% in the latter group (P<0.001). On the post-ictal EEG, intermittent rhythmic delta activities were observed in 28.6% and periodic lateralized epileptic discharges in 21.4% of the seizure patients.
Seizures are more prone to occur in patients with frontal lobar haematomas. EEG can be helpful for the diagnosis of seizures in approximately 50% of the cases.
脑出血（ICH）患者癫痫发作的频率高于脑梗死患者。然而，与脑出血相关的癫痫发作的危险因素尚不太清楚。
回顾性比较接受药物治疗的自发性脑出血且发生癫痫发作的患者与未发生癫痫发作的患者的特征。
2004年至2006年期间，14名因脑出血相关癫痫发作入住卒中单元的患者。将他们的特征与2002年至2004年期间因脑出血入住但随后未发生癫痫发作的51名患者的特征进行比较。
6名脑出血相关癫痫发作患者（42.9%）出现卒中发作后48小时内的早发性癫痫发作。8名患者出现迟发性癫痫发作，平均在脑出血后8个月。75.7%的病例记录为癫痫发作灶性发作。21.4%的患者出现癫痫持续状态。仅28.6%的患者癫痫复发。癫痫发作组78.6%存在脑叶血肿，而对照组为21.4%（P = 0.008）。前一组57.1%存在额叶受累，而后一组为9.8%（P < 0.001）。在发作后脑电图上，28.6%的癫痫发作患者观察到间歇性节律性δ活动，21.4%观察到周期性一侧性癫痫样放电。
额叶脑叶血肿患者更容易发生癫痫发作。脑电图在大约50%的病例中有助于癫痫发作的诊断。
