脑卒中后继发癫痫患者临床表现、脑电图及MRI特征OA

Objective To analyze the clinical manifestations,electroencephalogram,and MRI features of patients with post-stroke epilepsy(PSE).Methods A total of 93 patients with PSE admitted to the hospital from January 2022 to August 2025 were selected.The relationship between epileptic seizure type and electroencephalogram/MRI features,relationship between stroke type and epileptic seizure type/duration,as well as the relationship between different epileptic seizure types and lesion localization using MRI and epileptiform discharges in the electroencephalogram were analyzed.Results Among 93 PSE patients,the seizure time included early-onset epilepsy(42 cases,45.16%)and late-onset epilepsy(51 cases,54.84%).The seizure types included generalized tonic-clonic seizures(24 cases,25.81%),focal seizures(31 cases,33.33%),complex partial seizures(20 cases,21.51%),and focal to generalized tonic-clonic seizures(18 cases,19.35%).The proportions of generalized tonic-clonic seizures in patients with cerebral hemorrhage and subarachnoid hemorrhage(36.36%and 55.00%)were higher than those in patients with cerebral infarction and cerebral thrombosis(6.67%and 11.11%).The proportions of focal seizures in patients with cerebral infarction and cerebral thrombosis(60.00%and 41.67%)were higher than those in patients with cerebral hemorrhage and subarachnoid hemorrhage(18.18%and 15.00%)(P<0.05).The proportions of early-onset epilepsy in patients with cerebral hemorrhage and subarachnoid hemorrhage(59.09%and 75.00%)were higher than those in patients with cerebral infarction and cerebral thrombosis(26.67%and 27.78%).The proportions of late-onset epilepsy in patients with cerebral infarction and cerebral thrombosis(73.33%and 72.22%)were higher than those in patients with cerebral hemorrhage and subarachnoid hemorrhage(40.91%and 25.00%)(P<0.05).No statistically significant differences were observed in the proportions of lesions synchronously localized by MRI and epileptiform discharges in the electroencephalogram or in the proportion of lesions on the same side identified by epileptiform discharges in the electroencephalogram among different seizure types(P>0.05).Conclusion The epileptic seizure type and time in patients with PSE are closely related to the type of stroke.Electroencephalogram can monitor epileptiform discharges and MRI can assist in lesion localization,providing reference for clinical diagnosis and treatment.