颅脑外伤与继发性癫痫关系的临床观察及药物治疗.pdfVIP

· 198 · 安 徽 医 药 AnhuiMedicalandPharmaceuticalJournal 2010Feb；14(2) 颅脑外伤与继发性癫痫关系的临床观察及药物治疗 张道兵 (安徽省舒城县人民医院脑外科，安徽 舒城 231300) 摘要：目的 探讨颅脑外伤与继发性癫痫的关系及药物治疗。方法 回顾分析421例颅脑外伤患者中47例继发性癫痫患者的 临床资料，研究癫痫与损伤类型、颅脑损伤严重程度、脑电图检查情况及损伤部位的关系。结果 开放性脑损伤癫痫发生率 (28．21％)，明显高于闭合性脑损伤 (7．29％)；重伤癫痫发生率 (24．11％)明显高于轻伤 (3．47％)；顶叶损伤癫痫发生率最高 (55．31％)；外伤性癫痫首次脑电图检查异常率为80．85％。经两年抗癫痫治疗 ，发作完全控制。结论 脑外伤后继发性癫痫 以开放性损伤、重度损伤发生率高，顶叶损伤最易发生癫痫 ，以部分性发作居多 ，脑电图检查在本病的诊断和指导治疗中具有重 要意义。对于具有癫痫高危因素的颅脑外伤患者可使用抗癫痫药物预防癫痫发作，积极处理原发伤 ，合理治疗，可降低发病率， 选择恰当的方法治疗癫痫，可提高疗效。 关键词：颅脑外伤 ；继发性癫痫；临床观察；药物治疗 Clinicalobservationandtreatmentforsecondary epilepsy inpatientswithtraumaticbraininjure ZHANG Dao．bing (DepartmentofNeurosurgery，TheShuchengPeople’sHospital，Shucheng231300，China) Abstract：Aim Toinvestigatetherelationsoftraumaticbraininjury(TBI)andsecondaryepilepsyinpatientsafteroperationandmedi— cinetreatment．Method FortysevencasesofTB1withsecondary epilepsypatientSclinicalsmaterialhadbeenanalyzedfetrosgectively from 421cases，Relationsbetweenepilepsyanddamagetype，TBIseriousnees，electroencephalogram，andthedamagespotwerestudied． Results TheopenTB1withsecondaryepilepsyincidencerate(28．21％)obviouslywashigherthantheclosedbraininjury(7．29％)． Theseverelywoundedepilepsyincidencerate(24．11％)wasobviousyhigherthantheminorinjury(3．47％)．Theparietallobedamage epilepsyformationratewasthehighest(55．31％)．Thetraumaticepilepsyelectroencephalogram inspectionrateofabnomralitywas80． 85％ forthefirsttime．Aftertwoyearsna ti—epilepsy，satisfactory resuhswereachieved．Conclusions TheformationrateofTB1withsee- ondaryepilepsyishigherintheofteratingopeninjuryandheavydamage，andtheparietallobedamageisthereaultinsequentialepilep- sy，withamajorityofpartialseizures．Electroencephalogramhasavitalsignificanceinthediagnosisandinstructiontreatmentinthissick． Regardinghasepilepsyh