Factors related to elderly post-stroke secondary epilepsy

Tao ZHANG; Jiyou TANG

ABSTRACT

BACKGROUND:

Elderly post-stroke secondary epilepsy is the main cause of elderly epilepsy, and has a certain effect on the rehabilitation and prognosis of stroke.

OBJECTIVE:

To probe into the association of post-stroke epileptic attack with the type, location and size of stroke.

DESIGN:

A case analysis.

SETTING:

the Department of Neurology, Qianfoshan Hospital of Shandong Province.

PARTICIPANTS:

Between January 1999 and December 2004, 68 inpatients (42 males and 26 females) with post-stroke secondary epilepsy, aged 60-83 years with an average of (68±7), were selected from the Department of Neurology, Qianfoshan Hospital of Shandong Province, and all the patients participated in the study voluntarily.

METHODS:

[1] According to the time of the first attack of post-stroke epilepsy, the patients were divided into early epilepsy (within 2 weeks post stroke) and delayed epilepsy (after 2 weeks post stroke), and the correlation between the time of epilepsy attack and types of stroke was analyzed. [2]Based on the imaging results, the ischemic stroke (including cerebral thrombosis and cerebral embolism) was divided into groups of ＜ 1/4, 1/4-1/2, ＞1/2 of unilateral hemisphere according to the infarcted size, and divided into groups of ＜ 20 mL, 20-40 mL, and ＞ 40 mL according to the amount of cerebral hemorrhage, and the association of epileptic attack with the stroke location and size was analyzed. [3] All the patients received symptomatic treatment, and they were followed up for 6 months to 4 years with an average of 21 months by means of reexamination. [4] The differences of the enumeration data were compared with the χ2 test.

RESULTS:

All the 68 patients with post-stroke epileptic attack were involved inthe analysis of results. [1] The correlation between the time of epileptic attack and type of stroke The cases of cerebral hemorrhage and subarachnoid hemorrhage were obviously more in the patients with early epilepsy than in those with delayed epilepsy (10, 2 cases; 4, 0 case, P ＜ 0.05),and the cases of cerebral thrombosis were obviously fewer in the patients with early epilepsy than in those with delayed epilepsy (3, 36 cases, P ＜ 0.05). [2]The association of epileptic attack with the stroke location and size There were more cases with the infarcted size of 1/4-1/2 and ＞1/2 of unilateral hemisphere than those with the infarcted size of ＜ 1/4 of unilateral hemisphere (26, 17, 9 cases, P＜ 0.05). There were more cases with the 20-40 mL and ＞ 40 mL cerebral hemorrhage than those with ＜ 20 mL cerebral hemorrhage (4, 9, 1 case, P ＜ 0.05). [3] The prognosis of epileptic attack Of the 21patients with early epilepsy, epilepsy was the first symptom in 6 cases, and no re-attack occurred within 2 weeks in 15 cases. Of the 47 patients with delayed epilepsy, the disease after 1 year was completely controlled in 18 cases,better controlled in 23 cases, and the attack was frequent in 6 cases.

CONCLUSION:

[1] Early epilepsy is mainly manifested by cerebral hemorrhage, subarachnoid hemorrhage and cerebral embolism, and delayed epilepsy is mainly manifested by cerebral thrombosis. [2] The risk of epilepsy is obviously increased in the patients with the infarcted size over 1/4 of the unilateral hemisphere, and those with ＞ 40 mL cerebral hemorrhage. [3] The prognosis of early epilepsy is better.