Semra Şengün KARAÇAYIR, Kemal BALCI, Talip ASİL, Yahya ÇELİK

Beyin damar hastalığı sonrası gelişen epileptik nöbetler

Amaç: Beyin damar hastalığı geçiren hastalarda epileptik nöbet sıklığı araştırıldı. Hastalar ve Yöntemler: Üç yıllık bir sürede beyin damar hastalığı ile başvuran 1273 hastanın verileri retrospektif olarak değerlendirildi. Çalışmaya beyin damar hastalığı sonrası epileptik nöbet geçiren 160 hasta (130 iskemik, 30 hemorajik) alındı. İnme risk faktörleri ile nöbet gelişimi arasındaki ilişki, nöbet tipleri, elektroensefalografi bulguları, nöbetlerin zamansal dağılımı, lezyon tipi ve lokalizasyonu değerlendirildi. Aynı dönemde kliniğimizde takip edilen beyin damar hastalığı olan 640 hasta da kontrol grubu olarak alındı. Bulgular: Üç yıl boyunca takip edilen beyin damar hastalarının ortalama bir aylık takip süresinde nöbet geçirme oranı %12.6 bulundu. Multivaryant analizle, iskemik beyin damar hastalığı olanlarda kortikal tutulum, enfeksiyon ve metabolik bozukluk varlığı; kanayıcı beyin damar hastalığı olanlarda ise kortikal lezyon ve enfeksiyon nöbet gelişimi için bağımsız risk faktörleri olarak saptandı. Total anterior sirkülasyon infarktı olan hastalarda nöbet gelişimi istatistiksel olarak anlamlı derecede yüksek bulundu. Sonuç: Kortikal lezyonlu ve anterior sirkülasyon lezyonlu hastalarda nöbet gelişim oranı daha yüksek bulundu ve nöbet geçiren hastaların mortalitesi yüksekti. Ayrıca beyin damar hastalığı sonrası gelişen nöbetlerin çoğu jeneralize tonik klonik tipteydi.

Anahtar Kelimeler:

Geriyedönük çalışma, Serebral enfarktüs, Nöbetler, Serebral kanama, Serebrovasküler bozukluklar

Epileptic seizures following cerebrovascular disease

Objectives: Evaluation of the frequency of epileptic convulsions in patients with cerebrovascular disease. Patients and Methods: The data of 1273 patients with cerebrovascular disease, admitted within three years, were evaluated retrospectively. 160 patients (130 ischemic, 30 haemorrhagic) with epileptic seizures, developing after cerebrovascular diseases were included in this study. The association between the risk factors of stroke and seizure development, types of seizures, electroencephalographic findings, time distribution of seizures, types and localisations of lesions were evaluated. 640 patients with cerebrovascular disease, admitted to our clinic at the same time period, were included as control subjects. Results: The ratio of epileptic convulsions within one month follow-up period was 12.6% for all patients during the three years follow-up. Multivariant analyses revealed that independent risk factors for convulsion were cortical localisation of lesions, infections and metabolic disturbances were in patients with ischemic cerebrovascular disease and cortical lesions and infections in patients with haemorrhagic cerebrovascular disease. The ratio of convulsion was significantly higher in patients with total anterior circulation ischemic lesion. Conclusion: Patients with cortical lesions and anterior circulation lesions had an increased risk for convulsions, and convulsions increased mortality. Most of the seizures in patients with cerebrovascular disease were of generalised tonic clonic type.

Keywords:

Retrospective Studies, Cerebral Infarction, Seizures, Cerebral Hemorrhage, Cerebrovascular Disorders,

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