De Reuck Jacques L
Stroke Unit, Department of Neurology, University Hospital, Gent, Belgium.
Neurol Neurochir Pol. 2007 Mar-Apr;41(2):144-9.
No guidelines exist concerning risk factors, diagnosis, management and treatment of stroke-related seizures. Seizures related to intracerebral haemorrhages occur in 10.6%, while those related to ischaemic stroke appear in 8.6%. Early-onset seizures have a poor prognosis with a high in-hospital mortality rate. They occur significantly more often in patients with haemorrhagic strokes. The recurrence rate is low. Late-onset seizures occur mainly between 6 months and 2 years after stroke with a high recurrence rate. Patients with a partial anterior circulation syndrome, a large cortical infarct with irregular borders, located in the parieto-temporal regions, are mainly at risk. Post-stroke seizures are harmful and require treatment with antiepileptic drugs. Post-stroke EEG can help to predict those patients who are at risk of developing seizures. The difference between early- and late-onset seizures is arbitrary as 20% of seizures occurring in patients with a previous cerebral infarct are the clinical expression of a new stroke.
目前尚无关于中风相关性癫痫发作的危险因素、诊断、管理及治疗的指南。与脑出血相关的癫痫发作发生率为10.6%，而与缺血性中风相关的癫痫发作发生率为8.6%。早发性癫痫预后较差，院内死亡率高。它们在出血性中风患者中显著更常见。复发率较低。迟发性癫痫主要发生在中风后6个月至2年之间，复发率高。具有部分前循环综合征、位于颞顶叶区域的边界不规则的大面积皮质梗死的患者主要有发病风险。中风后癫痫有害，需要使用抗癫痫药物治疗。中风后脑电图有助于预测有癫痫发作风险的患者。早发性和迟发性癫痫之间的区别是人为划定的，因为既往有脑梗死患者中20%的癫痫发作是新中风的临床表现。
