뇌경색 후 간질- 임상양상과 발생기전을 중심으로

다국어 초록 (Multilingual Abstract)

Background : Cerebral infarction is one of the most important causes of adulthood epilepsy. This study is designed to investigate predictive factors of post-infarct epilepsy (PIE). Methods : Between January 1996 and December 1997, 550 patients were admitted to the Department of Neurology at Chonnam National University Hospital (CNUH) with their first ever ischemic stroke. Among them, twenty-three patients developed epileptic seizures within one year after the cerebral infarction. We analyzed their clinical manifestations including semiology, onset time of seizures, EEG findings as well as subtypes, sites and sizes of the infarcts. Results : The incidence of PIE in CNUH was 4.2%. Partial seizures accounted for 86.9% and late epilepsy accounted for 73.9 % of them. After classifying subtypes with TOAST classification, we found that the proportion of stroke subtype in PIE was quite different from those of the total patients: large-artery atherosclerosis in 52.2%, cardioembolism in 39.1%, undetermined etiology in 4.3% and small-vessel occlusion in 4.3%. The infarcts were located supratentorially in all the patients with PIE, especially frequently in the peri-Rolandic area. PIE was not related to the lesion size. Conclusion : PIE tends to have a late onset, and manifests frequently as partial seizures. Therapeutic responses are good. PIE is closely related to cardic embolism and supratentorial location. Korean Journal of Stroke 2000;2(2): 164~170