Risk Factors Of Post-stroke Epilepsy In Patients With Acute Cerebral Infarction And Its Correlation With Cognition,anxiety And Depression

Objective To explore the risk factors of post-stroke epilepsy in patients with acute cerebral infarction and its correlation with patients’cognition,anxiety and depression,so as to provide clinical evidence for improving the prognosis of stroke.Methods Part Ⅰ:A retrospective case analysis method was used to collect 972 patients with acute cerebral infarction who were hospitalized from June 2016 to June 2018 without previous epileptic seizures.Through in-patient medical records and telephone follow-up,the demographic data(including gender,age),high risk factors of stroke(including hypertension,diabetes,smoking,alcohol consumption,atrial fibrillation,blood lipid status),clinical characteristics(stroke severity,focal area and location,early epileptic seizures,hemorrhagic transformation,stroke subtypes)were collected in detail.According to whether epilepsy occurs or not,the patients were divided into post-stroke epilepsy group(PSE group)and non-post-stroke epilepsy group(non-PSE group).The data of the two groups were compared.Chi-square test,independent sample t-test and logistic regression analysis were used to analyze the influence of related factors on post-stroke epilepsy.The difference was statistically significant(P<0.05).Part Ⅱ:A prospective case analysis method was used to collect 114 patients with acute cerebral infarction who were hospitalized from from April 2018 to July 2018 without previous epileptic seizures.The patients who met the criteria were scored by MMSE,MOCA,SAS and SDS at the initial stage and 6 months after onset.According to whether epilepsy occurs or not,the patients were divided into post-stroke epilepsy group(PSE group)and non-post-stroke epilepsy group(non-PSE group).The data of the two groups were compared.The mean t-test or U-test of independent samples were performed by SPSS 19.0,and the difference was statistically significant(P<0.05).Results Part Ⅰ:1.Among 972 patients,59 had post-stroke epilepsy,while 913 had no epilepsy during the period from onset to end of follow-up.The incidence of post-stroke epilepsy was 6.1%.2.Univariate analysis showed that age,history of atrial fibrillation,history of hypertension,NIHSS score>14,large-area infarction,early epilepsy,cortical involvement were correlated with post-stroke epilepsy.Gender,past history of diabetes,smoking,drinking,TG,TC,LDL,hemorrhage transformation,stroke classification were not correlated with post-stroke epilepsy.Multivariate logistic logistic regression analysis showed that there was no significant correlation between post-stroke epilepsy and age.Regression analysis showed that age,NIHSS score>14,massive infarction,early epileptic seizures and cortex involvement were high risk factors for post-stroke epilepsy.3.Among 59 cases of post-stroke epilepsy,32 cases(54.2%)had general seizures,27 cases(45.8%)had partial seizures,49 cases(71.2%)had seizures less than 3 times/3 months,and 10 cases(28.8%)had seizures more than 3 times/3 months.Part Ⅱ:1.Compared with non-PSE group,there was no significant difference in MOCA score and MMSE score between PSE group and non-PSE group at admission(P>0.05);compared with admission,MOCA score and MMSE score of PSE group and non-PSE group decreased at 6 months of onset(P<0.05);compared with non-PSE group,MOCA score and MMSE score of PSE group decreased at 6 months of onset(P<0.05).2.Compared with non-PSE group,there was no significant difference in SAS score and SDS score between PSE group and non-PSE group at admission(P>0.05).Compared with admission,there were significant differences in SAS score and SDS score between PSE group and non-PSE group at 6 months of onset(P<0.05).Compared with non-PSE group,there were significant differences in SAS score and SDS score between PSE group at 6 months of onset(P<0.05).Conclusions 1.Age,NIHSS score>142,massive infarction,early epileptic seizures and cortex involvement are high risk factors for post-stroke epilepsy.History of hypertension and atrial fibrillation are correlated with post-stroke epilepsy.2.Sex,past history of diabetes mellitus,smoking,drinking,TG,TC,LDL,and ischemic stroke typing have no significant correlation with the occurrence of post-stroke epilepsy.3.There is a correlation between epilepsy after stroke and cognitive impairment in patients with acute cerebral infarction,and the main manifestation is at 6 months after stroke.4.Post-stroke epilepsy is correlated with anxiety and depression in patients with acute cerebral infarction,mainly in 6 months after stroke.