Rối loạn tâm thần ở bệnh nhân động kinh cục bộ phức tạp sau nhồi máu não

dd vi thwc hinh cua ngudi din vi ngudn nwdc sinh hogt,

nhi ti6u tgi quin Thanh Xuin- Hi Ndi vi quin Chiu Giang

Hung Yin nim 1998". Lugn vSn thgc sy y t l cdng cgng.

Thai Binh, tr.64-81.

5. Bg Y tl, Tdng cgc Thdng kg (2003), Sgo do kit

qui diiu tra y ti Qudc gia 2001-2002, Hg Ngi, 2003, Nhg

xuit ban Y hpc.

6. Bg Y t l (2005), Tiiu chuin v$ sinh nwdc sgch vi

tiiu chuin vg sinh ddi vdi dc logi nhi tiiu. Hi NOi-2005, tr.

12-13.

7. TrIn Hu'u Hgnh (2005), "Dinh gii cdng tic phdng

ehdng b$nh tiiu chiy tgi tuyin xS huyin Ddng Hung, Thdi

Binh nim 2005", Lugn gn Bgc sy Chuygn khoa d p II, Thai

Binh-2005.

8. Hgi bao vg thign nhign vg mdi trudng Vigt Nam

(2004), Vi$t Nam mdi tnrdng vi cude sdng, Nhg xuit ban

Chinh tri Qudc gia, Hg Ngi-2004.

9. Lg Thj Song Huang, Odng Trung Kign (2006),

"Ognh gia higu qua dy gn cai thign cung d p nudc sgch va

vg sinh mdi trudng ndng thdn tgi huygn An Duang Hai

Phdng", Tgp chi Y hgc dw phdng, tgp XVI, s6 2(82), tr. 50.

Rdi LOAN TA M THA N QT BENH NHA N DdNG KINH CUC Bd PHU^C TAP SAU NHdl NlAU NAO

T6M TAT:

Mgc tiiu nghiin ciru: Phit hign cic roi logn tim

thin tren bgnh nhin dgng kinh cgc bg phirc tgp sau nhdi

miu nio. Doi tirgng nghien ciru: 32 bgnh nhin dwgc

chin doin dgng kinh cgc bg phuc tgp sau nhdi miu nao

dwgc diiu tri ngogi tni vi ndi trii tgi Vign Sire khde Tim

thin, Bgnh vign Bgch Mai tu thing 01 nim 2006 den hit

thing 3 nim 2010. Phwomg phap nghien eu'u: nghien

cuv tien cuv nhim danh gii cic roi logn tim thin tren

binh nhin cd dgng kinh cgc bd phirc tgp. Kit qua

nghien ciru & Ket lu$n: Tudi mic bgnh tren 55 tudi

chiim ty lg 59,4%, ty lg nam/nCr li 0,68. Yiu td nguy ca

li rdi logn chuyin hoi lipit chiim 46,9%; b$nh ly tim

mgch chiim 37,5%; thdi gian bj binh sau khi bj nhdi

miu nSo tw 01 den 02 nim chiim 56,4%. Diu higu bio

trwdc cua can dgng kinh cgc bd phirc tgp xiy ra dan dgc

chiim 75,0% ; 100% bgnh nhin cd rdi logn y thirc trong

dd rdi logn y thuc hoing hdn chiim 65,6%; 78,1% bgnh

nhin cd io thj. Giai the nhin cich chiim 62,5%>; kieh

ddng chiim 50% sd bgnh nhin. Sd bgnh nhin cd hai

triiu chung rdi logn tim thin nhw hoang twang kit hgp

kich ddng chiim 25,0% sd bgnh nhin; giai thi nhin

cich kit hgp hoang twang chiim 21,9%; thdi gian keo

dii ciia can dwdi 05 phut chiim 63,3%; 25% bgnh nhin

cd tren 02 d nhdi miu vi 46,9% cd d nhdi miu d viing

thii duang.

Tir khda: rdi logn tim thin, dgng kinh cgc bg, nhdi

miu nio.

SUMMARY:

Mental disorders in the patients with complex

partial seizures after cerebral infarct

Aims: To investigate mental disorders on the

patients with complex partial seizures after cerebral

infarct Objective: 32 patients with with complex partial

seizums after cerebral infarct were treated in Institue of

Mental Health - Bach Mai Hospital from January, 2006

to March, 2010. Method: prospective study. Result &

Conclusion: The morbidity age of patients above 50 is

59.4%, the male - female ratio is 0.68. The high risks

are lipid metabolism disorder (46.9%); cardiovascular

disease (37.5%); the onset time from 1 to 2 years after

cerebral infarct (56.4%). The occurrence of precede

signs in a complex partial seizure is single in 75.0% of

the patients; 100% patients have the disturbance of

consciousness, including sunset awareness disorder

NGUYIN DOAN PHUONG

Vi^n Sdc khoi Tim thin - B^nh vi^n B§ich Mai

(65.6%); 78.1% patients have visual hallucination;

depersonalization (62.5%); agitation (50%). The

comorbidity of delusion and agitation is 25.0%; the

comorbidity of depersonality and delusion is 21.9%; the

lasted time of the seizure under 5 minutes is 63.3%;

25% of the patients have above 2 infarctions and 46.9%

have the infarction in temporal area.

Keywords: mental disorders, complex partial

seizures, complex partial seizures, cerebml infarct

DAT VAN Dt

Dpng kinh cgc bp phii'c tgp (G40.2) la nhirng thay

ddi hanh vi tirng can xay ra khi y thu'c bj mit vdi mdi

trudng thye tgi. Trudc kia cdn gpi la dpng kinh thai

duang, dpng kinh tam thin vgn dpng. Dgng kinh cgc bg

phue tgp cd dgc dilm la mit y thire tir diu hogc thir

phat, rdi logn sy d m nhgn, trong can cd nhirng thay doi

hanh vi hoac la ao tudng, ao giae vg cd nhO'ng hanh vi

ty dpng va quen hoan toan sau can. Dgng kinh cgc bg

phirc tgp xam phgm ngay tir diu hoac thir phat thuy thgi

duang hogc thuy tran.

Neu chin doan dpng kinh cgc bp phii'c tgp khdng

phan bipt dupe can rdi logn tam thin trong dpng kinh

cgc bp phirc tgp vdi cac bpnh tam thin khgc vigc dilu trj

se khdng dgt kit qua, dgc bipt nhCrng bgnh nhgn sau

nhdi mau nao. Vi thi ehiing tdi tiln hanh nghign ciru:

"Roi logn tim than ir bgnh nhin dgng kinh cgc b^

phdc tgp sau nhdi miu nao" nhim mgc dieh phat hign

va danh gia cic rdi logn tam thin tirng can d bgnh nhgn

cd tiln sir nhdi mag nao.

D 6 | TUCP-NG vA PHU'ONG PHAP NGHIEN eUU

1. Doi twgng nghien ciru.

La 32 bpnh nhan duyc chin doan dpng kinh cgc bg

phirc tgp sau nhdi mau nao dupe dilu tri ngogi tai vg

npi tru tgi Vipn Sire khde Tam thin, Bgnh vign Bgch Mai

tir thang 01 nam 2006 din hit thang 3 nam 2010.

2. Tieu chuan chgn bgnh nhan:

Chung tdi dya vao tieu chuin chin doan cua T6

chirc Y t l Thi gidi ICD-10/1992, eg thi gdm ed:

- Lam sgng •*• dipn nao dd bpnh ly

+ Lgm sang:

- Cd can phii hpp vdi logi can dpng kinh cgc bg

phirc tgp mgc G40.2.

- Cd bilu hipn rdi logn y thire.

- Cd bilu hign thit ngdn.

- cac bilu hign ban nang, d m xiic hay ggp nhit Id

28 Y HOC THUC HAN H (741) - SO 11/2010