缺血性卒中和出血性卒中后癫痫发作的发生率、影响和处理。
Incidence, Implications, and Management of Seizures Following Ischemic and Hemorrhagic Stroke.
机构信息
Division of Clinical Neurophysiology, Department of Neurology, Weill Cornell Medical College, 525 East 68th Street, New York, NY, 10065, USA.
Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, 10065, USA.
出版信息
Curr Neurol Neurosci Rep. 2019 May 27;19(7):37. doi: 10.1007/s11910-019-0957-4.
PURPOSE OF REVIEW
In this review, we summarize the recent literature regarding the incidence and treatment of seizures arising after ischemic and hemorrhagic strokes. Additionally, we identify open questions in guidelines and standard clinical care to aid future studies aiming to improve management of seizures in post-stroke patients.
RECENT FINDINGS
Studies demonstrate an increasing prevalence of seizures following strokes, probably a consequence of advances in post-stroke management and expanding use of continuous EEG monitoring. Post-stroke seizures are associated with longer hospitalization and increased mortality; therefore, prevention and timely treatment of seizures are important. The standard of care is to treat recurrent seizures with anti-epileptic drugs (AEDs) regardless of the etiology. However, there are no established guidelines currently for prophylactic use of AEDs following a stroke. The prevalence of post-stroke seizures is increasing. Further studies are needed to determine the risk factors for recurrent seizures and epilepsy after strokes and optimal treatment strategies.
目的综述
本篇综述总结了缺血性卒中和出血性卒中后发作性癫痫的发病率和治疗方法的最新文献。此外，我们还确定了指南和标准临床护理中的一些开放性问题，以帮助未来的研究，旨在改善卒中后患者癫痫发作的管理。
最近的发现
研究表明，卒中后癫痫发作的患病率呈上升趋势，这可能是由于卒中后管理的进步和连续脑电图监测的广泛应用所致。卒中后癫痫发作与住院时间延长和死亡率增加有关；因此，预防和及时治疗癫痫发作非常重要。标准治疗方法是使用抗癫痫药物（AEDs）治疗复发性癫痫，无论病因如何。然而，目前尚无关于卒中后预防性使用 AEDs 的既定指南。卒中后癫痫发作的患病率正在增加。需要进一步研究以确定卒中后复发性癫痫和癫痫的危险因素以及最佳治疗策略。
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