Analysis Of The Risk Factors Of Epilepsy After Ischemic Stroke And Its Clinical Study Of Concurrent Anxiety And Depression

ObjectiveTo analyze the risk factors of epilepsy after ischemic stroke and its correlation with anxiety and depression.MethodsPart I: This study is a case-control study.Patients with the first acute cerebral infarction hospitalized in our hospital from January 2019 to December 2020 were followed up for 1 year.A total of 50 patients with ischemic post-stroke epilepsy were included in the post-stroke epilepsy（PSE）group,including 27 males and 23 females;50 patients without epilepsy from the same period to the end of follow-up were collected.Their age,gender,neurological deficit symptoms,cognitive status and activities of daily living were similar to those in PSE group.A total of 50 patients,including 26 males and 24 females,were included in non PSE group.Demographic data,including age,gender,past history,including history of hypertension,diabetes,history of coronary heart disease,history of atrial fibrillation,smoking history,drinking history,were collected through in-patient records,face-to-face and telephone follow-up.Laboratory indexes（including triglyceride [TG],total cholesterol [TC],low density lipoprotein [LDL],serum homocysteine [Hcy],serum uric acid [SUA]）Clinical features（including whether there is early epileptic attack,the severity of cerebral infarction,whether it is a large-area infarction,whether it involves the cortex,whether the infarction has bleeding transformation,and whether it is complicated with pulmonary infection）were compared between the two groups,using spss25 0 chi square test,Fisher exact probability method,independent sample t-test,U-test and logistic regression analysis were used to study the influence of relevant factors on post-stroke epilepsy,and the difference was statistically significant（P < 0.05）.Part II: This study is a cross-sectional study.According to the inclusion and exclusion criteria,76 patients in the ischemic post-stroke epilepsy group and 76 patients in the control group were selected from January 2018 to December 2021,All patients were assessed with 14 items of Hamilton Anxiety Scale（HAMA）and 24 items of Hamilton Depression Scale（HAMD）at admission and 6 months after stroke.The data of the two groups were compared by spss25 There was no significant difference between the parameters of rank and P < 0.05.ResultsPart I: 1.Comparison of two groups of general data showed that there were significant differences in age,diabetes history,drinking history,NIHSS score,cerebral infarction area,location of lesion and early seizure in two groups.P < 0.05,there was statistical significance.2.The comparison of blood lipid levels,Hcy and uric acid levels between the two groups showed that there were significant differences in Hcy,uric acid and total cholesterol levels between the two groups（P < 0.05）.3.multiple factors were included in the Logistic regression analysis model.It was concluded that age,seizure onset,NIHSS score,involvement of cortex,Hcy and uric acid were independent risk factors for epilepsy after cerebral infarction,with statistical significance（P < 0.05）,while diabetes history,drinking history,large area cerebral infarction,and infarction involving multi lobar lobe were not independent risk factors for epilepsy after cerebral infarction.There was no statistical significance（P > 0.05）.Part II: 1.Compared with that at admission,the HAMA and HAMD scores of the two groups were significantly increased at 6 months after onset（P < 0.05）,and the difference was statistically significant（table 5-6）.2.Compared with the control group,the scores of HAMA,HAMD and anxiety state in the post infarction epilepsy group were higher than those in the control group at 6 months after onset（P < 0.05）.Conclusion1.Age < 65 years old,early seizure,NIHSS score > 14,cortical involvement,high Hcy and SUA levels were all independent risk factors for epilepsy after cerebral infarction,while history of diabetes,drinking history,large-area cerebral infarction and involvement of infarct foci in multiple lobes were not independent risk factors for epilepsy after cerebral infarction.2.Compared with patients with ischemic stroke,patients with post-stroke epilepsy are more likely to be complicated with emotional problems of anxiety and depression.