Lamy C
Service de neurologie, hôpital Sainte-Anne,75014 Paris, France.
Rev Neurol (Paris). 2008 Oct;164(10):841-5. doi: 10.1016/j.neurol.2008.07.006. Epub 2008 Aug 27.
Stroke is associated with an increased risk of subsequent seizures and epilepsy. Cerebrovascular lesions are the leading cause of epilepsy in the elderly, ahead of degenerative disorders, brain tumors and head trauma, accounting for up to one-third of newly diagnosed seizures in this population. The frequency of seizures in stroke victims varies from 5 to 20%, but only a minority will develop epilepsy. Based on differences in their presumed pathophysiology, seizures after stroke are usually divided into early and late seizures, according to various definitions. Early seizures are usually defined as those occurring within one or two weeks after stroke; late seizures usually occur within the first year after stroke. Several risk factors of seizures have been identified; stroke subtype and cortical location being the best-characterized predictors of seizure development. The optimal timing and type of anti-epileptic treatment remain debated. Several findings suggest that the majority of first generation anti-epileptic drugs are not the best choice in stroke patients.
中风与随后发生癫痫和癫痫症的风险增加有关。脑血管病变是老年人癫痫的主要原因，超过退行性疾病、脑肿瘤和头部创伤，在该人群新诊断的癫痫发作中占比高达三分之一。中风患者癫痫发作的频率在5%至20%之间，但只有少数人会发展为癫痫症。根据推测的病理生理学差异，中风后的癫痫发作通常根据各种定义分为早期和晚期癫痫发作。早期癫痫发作通常定义为中风后一两周内发生的发作；晚期癫痫发作通常发生在中风后的第一年内。已经确定了癫痫发作的几个危险因素；中风亚型和皮质位置是癫痫发作发展最具特征的预测因素。抗癫痫治疗的最佳时机和类型仍存在争议。几项研究结果表明，大多数第一代抗癫痫药物对中风患者来说并非最佳选择。
