Influencing factors,clinical characteristics and prognosis of post-stroke epilepsy in elderly patients
Objective To analyze the influencing factors,clinical characteristics and prognosis of post-stroke epilepsy(PSE)in elderly patients.Methods A retrospective study was conducted.90 elderly patients with secondary epilepsy after is-chemic stroke admitted to Fifth People's Hospital of Nanchong City from March 2021 to March 2023 were included in PSE group,and 90 elderly patients with ischemic stroke but without epilepsy admitted to this hospital during the same period were included in control group.The basic information,past history,stroke-related disease information and neurological deficits were collected and compared between the two groups.The factors with statistically significant differences between both groups were used as independent variables,and presence or absence of secondary epilepsy was taken as dependent variable.Logistic regres-sion model was used to analyze the related factors affecting the occurrence of PSE in elderly patients with ischemic stroke.The types and characteristics of epilepsy in PSE patients,as well as the effects of PSE on the recovery of neurological function were analyzed.Results The proportions of patients with lesions involvement of cortex,NIHSS score ≥ 15,carotid circulation in-volvement,and post-infarction hemorrhage transformation in the PSE group were higher than those in the control group,and the differences were statistically significant(P＜0.05).Logistic multivariate analysis showed that lesion involvement of cortex(OR=1.533,95％CI 1.088-2.160),carotid circulation involvement(OR=1.373,95％CI 1.081-1.744),NIHSS score≥15 points(OR=1.499,95％CI 1.098-2.048)and hemorrhage transformation(OR=1.292,95％CI 1.109-1.505)were in-dependent risk factors for PSE.The type of early-onset epilepsy seizures was mainly focal seizures(46.87％),and the type of late-onset epilepsy seizures was mainly focal secondary generalized seizures(53.84％).The NIHSS score of the PSE group was higher than that of the control group at 8 h after admission,at discharge and at the last follow-up,with statistical signifi-cance(P＜0.05).Conclusion Lesion involvement of cortex,carotid circulation involvement,NIHSS score≥15 points and hemorrhage transformation are independent risk factors for PSE in elderly stroke patients.Early-onset epilepsy is mostly mani-fested as focal seizures,and late-onset epilepsy is mostly manifested as focal secondary generalized seizures.The occurrence of PSE can aggravate the neurological impairment of stroke patients and affect the recovery of neurological function.It is necessary to pay attention to the above high risk factors for early identification and early intervention in clinical practice.
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