摘要: 目的 总结402例颅脑外伤患者发生癫痫所具有的临床特征，分析致痫因素。 方法 回顾402例颅脑外伤患者的病例资料，从中筛选出发生癫痫的病例，总结癫痫的发作特点，分析癫痫发作与多个临床因素的关系。 结果 颅脑外伤后癫痫的发作与伤情、是否开放伤等因素密切相关，且早期癫痫的发生与脑挫裂伤、颅内血肿关系密切，晚期癫痫与外伤后脑软化灶关系密切。 结论 颅脑外伤后早期癫痫的发生主要是由于脑挫裂伤、颅内血肿等因素导致神经细胞兴奋性增强所引起，晚期癫痫主要是由于脑软化灶、瘢痕形成致痫灶的异常放电引起，因此外伤性癫痫应针对不同的时间采取相应的治疗。

    关键词: 颅脑损伤;癫痫

    Clinical analysis of the factors leading to epilepsy after craniocerebral injury

    ZHOU Chun，XUMin-hui，YANG Dong-hong

    (Department of Neurosurgery，Institute of Surgery Research，Daping Hospital，Third Military Medical University，Chongqing 400042，China)

    Abstact: Objective To analyse the epileptogenic factors according to the features of39patients with epilepsy among402patients with head injury.Methods Thirty-nine cases who suffered epilepsy were selected from402patients with head injury.The clinical factors that related to the onset of epilepsy in39cases were analysed.Result The onset of epilepsy after head injurywas in close relation to the factors which include the degree of head injury and open head inju-ry.The early onset of epilepsy was closely related to the contusion and laceration of brain and the intracranial hematoma.The delayed epilepsy was in closely related to solftening focus of brain after head injury.Conclusion The early epilepsy is triggered by the elevated excitabilitv of nerve cells primarily caused by the contusion and laceration of brain and the in-tracranial hematoma.The delayed epilepsy is caused by the abnormal discharge of epileptogenic focus formed by brain solftening focus and scar. ......