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目的:探讨脑干卒中后继发癫的临床表现及其可能机制。方法:回顾性分析我院10年来收治的脑干卒中继发癫癎患者的临床表现及脑电图结果。结果:①548例脑干卒中中有10例(1.8%)继发癫癎发作,发作类型依次为强直—阵挛发作、强直发作、阵挛发作、失神发作;②8例行脑电图检查5例正常,2例呈轻度异常出现散在快θ波增多,各联波率普遍减慢,仅1例重度异常表现为出现弥漫性δ波,双侧尖波、棘波短阵发放。结论:脑干卒中后癫癎为全面性发作,癎性发作可发生于各发病阶段,患者的脑电图异常率较低,改变较轻。血肿刺激、脑水肿、颅内压增高、缺血缺氧等可能是早期癫癎发作的主要机制,晚期癫癎发作则与胶质细胞增生、瘢痕形成、中风囊等致灶有关。
Objective: To investigate the clinical manifestations of secondary epilepsy after brain stem stroke and its possible mechanism. Methods: The clinical manifestations and EEG findings of patients with epilepsy secondary to brain stem stroke admitted to our hospital for 10 years were retrospectively analyzed. Results: ① Fifty-eight cases (1.5%) had epileptic seizures in ten (1.8%) patients with brainstem stroke. The seizure types were tonic-clonic seizure, tonic seizure and clonic seizure. Normal, 2 cases showed mild abnormal scattered fast θ wave increased, the wave rate of each connection generally slowed down, only 1 case of severe abnormalities showed diffuse δ wave, bilateral spike, spike burst release. Conclusion: Epilepsy is a comprehensive attack after stroke in brainstem. Epileptic seizures can occur in all stages of the disease. The abnormal rate of EEG in patients is lower and the changes are mild. Hematoma stimulation, cerebral edema, increased intracranial pressure, hypoxia and hypoxia may be the main mechanism of early epileptic seizures. Epileptic seizures are associated with glial cell proliferation, scar formation, and stroke capsule.