【摘要】 目的分析和探讨老年人急性脑梗死后早期痫性发作的临床特征、可能病理机制、药物治疗及其预后转归。方法对我科近5年收治的老年急性脑梗死早期癫痫发作16例患者临床资料进行回顾性分析。结果所有患者均在急性脑梗死后2周内癫痫发作,其中全面性强直-阵挛发作5例,局灶性运动性发作9例,局灶性癫痫持续状态2例。经抗癫痫药物治疗2～6月后停药,随访2年,14例无再发作,但仍有2例长期服卡马西平。结论老年人急性脑梗死后早期痫性发作在积极治疗脑梗死同时,应迅速控制癫痫发作,以减轻脑损伤。卡马西平或丙戊酸钠为一线首选药物,必要时可联合用药,患者一般预后良好。更多还原

【Abstract】 Objective To assess the clinical features,pathogenesis,value for medical therapy and prognosis for early epileptic seizures in elderly with acute cerebral infarction.Methods The clinical data of 16 elderly with early epileptic seizures after acute cerebral infarction treated recently in our department was analyzed retrospectively.Results All seizures initiated within two weeks after acute cerebral infarction and among them there were 5 patients with generalized tonic-clonic seizure,9 with focal motor seizure and 2 with focal status epileticus.Following up for 2 years after treated with anti-epilepsy drugs for 2 to 6 months and then to discontinue the therapy,14 patients had no epileptic seizures,but 2 had to take cabamazepine to control seizures.Conclusion It was important to rapidly control epileptic seizures to reduce brain damage besides treatment effectively for acute cerebral infarction.Most elderlies with early epileptic seizures after acute cerebral infarction had better results treated with effective anti-epilepsy drugs.更多还原