Epilepsy in the elderly
Belgin Petek Balcı1, Aytül Mutlu1, Feriha Özer2, Özlem Çokar1
1Haseki Education And Research Hospital, Neurology Department
2İstanbul Medipol University, Faculty Of Medicine, Department Of Neurology
Keywords: Epilepsy, seizure type, EEG; treatment; elderly patients
Abstract
OBJECTIVE: Epilepsy is a frequent disease in the elderly, but its aetiology, clinical presentation, comorbidities, and prognosis are different than younger patients. In this study, we investigated types of seizures, EEG findings and the cause of epilepsy in the elderly.
METHODS: We analyzed retrospectively 95 patients all of whom are 65 years old and over having an epileptic seizure fort the first time. Type of epilepsy, age, EEG findings, magnetic resonans imaging and/or cranial tomography findings, aetiology, comorbidities and antiepileptic medication were evaluated.
RESULTS: The average age of our patients was 75, and 50(56%) patients were males. In 95 patients, 55 (58%) had focal seizures, 36 (38%) had generalize tonic clonic seizures and 4(4%) had convulsive status epilepticus. The frequency of focal interictal epileptiform activity was 32,6% patients. Seizures were responsive to treatment as monotherapy in 81(%85) patients and as politherapy in 14(%15) patients. Our study showed that cerebrovascular disease was the most common (63%) aetiologic cause identified. There was no significant relationship between age and frequency of seizures and EEG abnormalities. However, a significant correlation was found between age and comorbidities.
CONCLUSION: Our results supported the focal seizure is the most common manifestation of epilepsy in the elderly. Cerebrovascular disease is the most common etiological cause of epilepsy in the elderly. Monotherapy is sufficient in the majority of patients. Continuous growth of the elderly population is increasing the need for accurate diagnosis and effective treatment.