De Reuck J, Nagy E, Van Maele G
Stroke Unit, Department of Neurology, University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium.
J Neurol Sci. 2007 Dec 15;263(1-2):75-8. doi: 10.1016/j.jns.2007.06.004. Epub 2007 Jul 3.
The relation between seizures and small subcortical infarcts is uncertain. The present retrospective study investigates whether differences are observed between patients with and without seizures following a lacunar stroke.
Thirty-seven patients with seizures and a prior history of a lacunar stroke were admitted to the Ghent University Hospital during 2000 and 2005. They were compared to 205 patients, admitted between 2002 and 2004, with an acute lacunar stroke and without epileptic spells on follow-up. Nine out of the 37 patients with seizures and 48 out of the 205 without seizures had a history of recurrent strokes.
No differences in vascular risk factors, distribution and frequency of the lacunes, degree of severity of the white matter changes and outcome were observed. On the Mini-Mental State Examination moderate to severe cognitive disturbances were observed in the seizure group and in some patients of the non-seizure group.
In the present study we found no evidence that seizures are directly induced by lacunar infarcts. The seizures appear to be part of a more global ongoing cerebral disorder probably leading to cognitive impairment.
癫痫发作与皮质下小梗死之间的关系尚不确定。本回顾性研究调查了腔隙性卒中后有癫痫发作和无癫痫发作的患者之间是否存在差异。
2000年至2005年期间,37例有癫痫发作且有腔隙性卒中病史的患者入住根特大学医院。将他们与2002年至2004年期间收治的205例急性腔隙性卒中且随访期间无癫痫发作的患者进行比较。37例有癫痫发作的患者中有9例,205例无癫痫发作的患者中有48例有复发性卒中病史。
在血管危险因素、腔隙的分布和频率、白质改变的严重程度及预后方面未观察到差异。在简易精神状态检查中,癫痫发作组和部分非癫痫发作组患者出现中度至重度认知障碍。
在本研究中,我们没有发现证据表明癫痫发作是由腔隙性梗死直接诱发所致。癫痫发作似乎是更广泛的持续性脑部疾病的一部分,可能导致认知障碍。