老年人癫痫与病因分析

探讨老年人癫痫的临床特点、病因和发病机理。方法：回顾分析了６２例老年癫痫患者的临床表现、ＣＴ、ＭＲＩ、ＥＥＧ、ＥＫＧ和血生化方面检查。结果：脑血管病是老年人癫痫常见的病因，其次为脑肿瘤、脑萎缩、心血管及糖尿病。３６例脑中风患者中，１２例在中风后２周内有癫痫发作，２４例在中风后２周后出现癫痫发作，５例脑出血和蛛网膜下腔出血病人在起病２４小时内出现癫痫发作。脑皮质梗塞和脑叶出血比皮层下和脑深部病变更易出现癫痫发作。对不同梗塞部位的观察发现，大脑中动脉供血区梗塞后癫痫的发生率高于大脑前动脉供血区梗塞。结论：对老年的癫痫病人应尽早做ＣＴ、ＭＲＩ、ＥＫＧ和血生化方面检查，明确病因和诊断，及时治疗。

Elderly Patients with Epilepsy and Analysis of Pathogenesis

Objective: To explore clinical features, the pathogenesis and pathogenetic mechanism of elderly patients with epilepsy. Methods:We studied 62 elderly patients with epilepsy. There were 42 male and 20 females with their ages ranging between 60 and 92 years. A retrospective analysis of the clinical features. CT. MRI. EEG. EKG and blood examination of 62 cases was carried out. Results: The cerebrovascular diseses were the most common pathogenesis in elderly patients with epilepsy. The epileptic seizure were usually secondary to brain tumors, brain atrophy, heart disease and diabetes, Of the 36 patients with strock, 12 cases had their first seizures within the first 2 weeks after strock ,and 24 developed epilepsy after 2 weeks. 5 patients with subarachnoid hemorrhages and cerebral hemorrhages occurred with 24 hours of the stroke onset. Seizures were significantly more common with cortical infarction and lobar hemorrhages than subcortical and deep lesions. seizures with middle cerebral artery territory infarction were significantly more frequent than anterior cerebral artery territory infarction. Conclusion: It was suggested that CT or MRI, EKG and blood examination sould early use in the evaluation of elderly patients with epilepsy, even though the clinical examination were normal. Those examination might be helpful for diagnosing of epilepsy and finding of pathogenesis in ederly patients.