前瞻性研究表明癫痫与卒中之间存在联系
2012-08-05 15:57:30   来源： 丁香园   作者：  评论：0 点击：

In a recent study, acute symptomatic seizures occurred in 6.3% of patients admitted to the hospital with a first stroke.^[1] This large, prospective study included 714 patients (315 women; 399 men; age range, 27-97 years) with a first stroke hospitalized in one of 31 Italian centers. Acute symptomatic seizures were defined as those that occurred within 7 days of the stroke. Patients with a history of seizures or prior strokes were excluded.

最近研究表明，在首先发生卒中并被送至医院的患者 中，6.3%的继发了急性的症状性癫痫。这项大型前瞻性研究中，714名患者（315名女性，399名男性；年龄在27-97岁之间）被包括在内，都是因 首发卒中而被收入院，这些医疗机构包括31个意大利的医疗中心。急性症状性癫痫被定义为发生在卒中7天内的癫痫。有癫痫病史或先发过卒中的患者被排除在 外。
The authors identified 2 independent predictors for acute symptomatic seizures in this stroke population: hemorrhagic stroke and cortical involvement. Those with primary intracerebral hemorrhage had the highest incidence (16.2%), while those with pure ischemic stroke had the lowest (4.2%). Patients with ischemic stroke with hemorrhagic transformation had an intermediate risk (12.5%). In addition, patients with cortical infarction had an odds ratio of 3.4 for a seizure compared with those with subcortical lesions.

本文作者认为在这些卒中继发的急性癫痫有两个独立的因素: 出血性卒中和皮质病变。先发皮质出血的患者有继发癫痫的最高几率（16.2%），而那些单纯缺血性卒中继发癫痫的几率最小（4.2%）缺血性卒中合并出血 改变的病例发生癫痫的可能性介于两者之间（12.5%）。皮质梗塞的病例相对于皮质下病变的病例发生癫痫可能性的比值比为3.4。
The most common seizure types were simple partial (37.2%), complex partial (18.6%), and secondarily generalized (14%). Electroencephalograms (EEGs) were performed in 34 (75.6%) patients with seizures. Just over a third of the EEGs showed epileptiform activity (35.3%). The other findings were slow waves (41.2%) and aspecific findings (20.6%). Only 1 (2.9%) EEG was normal.
最常见的癫痫发作为单纯发作（37.2%），复杂性发作（18.6%），以及继发性全身发作（14%）。对癫痫患 者中的34例（75.6%）进行了脑电图检查。只有三分之一的脑电图出现了癫痫改变（35.3%）。其他发现为慢波（41.21%）和非特异性改变 （20.6%）。只有一例脑电图（2.9%）是正常的。
Nearly three quarters of the patients who had seizures did so within the first 24 hours of their stroke. Patients with seizures had a 30-day mortality rate that was nearly double the rate in patients without seizures;12.5% vs 6.3%, respectively

四分之三的患者在卒中后24小时内发生了癫痫。发生癫痫的患者在30天内的死亡率是未发生癫痫组死亡率的2倍，即各自为12.5%和6.3%。