张利山

摘要：缺血性脑卒中在脑血管疾病中较为常见，其发病率在神经科中高居首位，致残率与致死率均较高，患者多为中老年人，发病后对患者的健康与安全均危害严重。伴随着人口老龄化的加剧，脑血管疾病患病率不断升高，导致缺血性脑卒中后癫痫的患病风险也相继提升。尽管近年来临床对于脑卒中疾病管理方面取得明显进步，但关于脑卒中后癫痫疾病相关问题的研究资料仍缺乏，对其疾病发生机制以及治疗方面仍需不断进行研究。而临床上依据脑卒中后癫痫首次发作时间将其划分为早发性与迟发性两种，对于早发性癫痫主张服用抗癫痫药物终止疾病发作，并不建议长期用药，大部分迟发性癫痫患者需长期用药，方能有效控制疾病，但不论是早发性或迟发性癫痫发作，通过合理抗癫痫药物治疗，大部分患者均可取得理想的控制效果。本研究针对缺血性脑卒中后癫痫发病机制与治疗进展等展开系统分析，旨在为缺血性脑卒中后癫痫发作的临床治疗提供科学的理论依据。

关键词：缺血性脑卒中;癫痫;临床特征

中图分类号：R742.1;R743.3                           文献标识码：A                             DOI：10.3969/j.issn.1006-1959.2019.18.013

文章编号：1006-1959（2019）18-0038-03

Abstract：Ischemic stroke is more common in cerebrovascular diseases， and its incidence rate is the highest in neurology. The disability rate and mortality rate are high. Most of the patients are middle-aged and elderly. The health and safety of patients after onset Both are serious. With the aging of the population， the prevalence of cerebrovascular diseases is increasing， and the risk of epilepsy after ischemic stroke has also increased. Although clinical progress has been made in the management of stroke diseases in recent years， research data on epilepsy-related problems after stroke is still lacking， and research on its mechanism and treatment of diseases still needs to be continuously studied. Clinically， according to the first episode of post-stroke epilepsy， it is divided into early-onset and late-onset. For early-onset epilepsy， it is recommended to take anti-epileptic drugs to stop the onset of the disease. It is not recommended for long-term medication， most of the delayed onset. Patients with epilepsy need long-term medication to effectively control the disease， but whether it is early-onset or late-onset seizures， most patients can achieve the desired control effect through reasonable anti-epileptic drugs. This study aimed to provide a scientific theoretical basis for the clinical treatment of epileptic seizures after ischemic stroke in order to analyze the pathogenesis and treatment progress of post-ischemic epilepsy.

Key words：Ischemic stroke;Epilepsy;Clinical features

缺血性腦卒中后癫痫指患者患缺血性脑卒中前无癫痫疾病，而发生缺血性脑卒中后在一定时间内发生癫痫，且非其他代谢病变与脑部病变引起。脑卒中后癫痫可发生于卒中各时期，其中在脑卒中后2周发生率较高，部分癫痫症状出现于卒中恢复期，少数出现于脑卒中后几年[1]。……