To assess the clinical-EEG aspects, characterization of subtypes, relationships with prognostic scales and the occurrence of death in elderly patients in the acute phase of nonconvulsive status epilepticus (NCSE).Methodology Clinical variables, EEG data, Status epilepticus severity score (STESS), and the Epidemiologybased mortality score in status epilepticus (EMSE) were related to the death of 96 patients who were over 60 years old, with NCSE.Results NCSE with coma was observed in 31 patients (19 non-subtle and 12 "subtle" SE) and focal NCSE with impairment of consciousness in 65 cases. There were no significant EEG differences according to the type of NCSE. Higher STESS scores occurred in the comatose NCSE patients when compared to those with focal NCSE and impairment of consciousness (4.8 ± 1.2 vs 3.7 ± 1.2; T-Test; p<0.001). It was observed that 25 (26%) elderly died, with a mean survival time of 19.3 days. Elderly people with a higher risk of death are those diagnosed with

The elevated incidence of epilepsy with onsetat over 50 years of age, in relation to the total number of new cases of epilepsy, has been ignored in the literature in recent decades 1 . Studies have shown that epilepsy affects approximately 1 to 2% of the elderly population, and the incidence increases progressively with the advance in age. These cases of epilepsy can occur due to an acute cerebral seizure or have no apparent precipitator 2,3 . On the other hand, there is consensus in the literature that epileptic seizures (ES) are more difficult to diagnose in the elderly for various reasons such as the difficulty in obtaining an accurate clinical history, a frequently atypical ictal presentation, difficulty in making a differential diagnosis between an epileptic and non-epileptic event [3][4][5][6] and due the occurrence of comorbidities 5,6 . Although epilepsy is considered to be one of the commonest neurological affections in the elderly, and despite the need to take public health measures due to the progressive increase in the elderly population, particularly in developing countries, no national (Brazilian) publications and only a few international ones on epilepsy in this age range were found.Thus, the objective of the present study was to evaluate the clinical and electroencephalographic aspects of ES and epilepsies in patients with late-onset ES at over 50 years of age, also considering different age ranges. METHODS PatientsFifty-five patients, consecutively attended at the neurological clinic of the Celso Pierro Hospital and Maternity ABSTRACTEpilepsy in older individuals has an elevated incidence. The objective of the present work was to evaluate the clinical, EEG and brain imaging aspects in patients showing late-onset epilepsy. Fifty-five patients with late-onset epilepsy (older than 50 years) were evaluated. They were composed of two groups according to the onset age of the epilepsy seizure (ES): 51-60 (G51-60) and over 60 (G60+) years. Focal ES predominated although they were less frequent in G60+. The occurrence of status epilepticus was high and more frequent in G60+ whereas seizures in series predominated in G51-60. Symptomatic epilepsy was more frequent and the vascular etiology predominated. Epileptiform activity was associated with a greater number of ES, and background activity abnormalities were more frequent in G60+. In conclusion, epilepsy with onset at over 50 was predominantly focal and symptomatic, with a high occurrence of status epilepticus and of seizures in series.Key words: epilepsy, aged, epileptic seizures, electroencephalography. RESUMOEpilepsia no idoso tem elevada incidência e peculiaridades pouco estudadas. O objetivo do presente trabalho foi avaliar aspectos clínicos e eletrencefalográficos de pacientes que apresentaram a primeira crise epiléptica (CE) tardiamente. Foram avaliados 55 pacientes com epilepsia tardia (com início após os 50 anos), divididos em dois grupos segundo a idade de início das CE: de 51-60 anos (G51-60) e após os 60 anos (G60+). Predominaram as CE focai...

RESUMO -Analisamos os aspectos clínicos de 25 pacientes consecutivos que apresentaram calcificação nos núcleos da base na tomografia computadorizada (TC) de crânio. Esta ocorreu em 0,68% de todos os exames realizados no período. Vinte e três pacientes apresentavam condições clínicas diversas, a saber: cefaléia em 7 casos, acidente vascular cerebral em 5, síndrome extrapiramidal em 2, processo expansivo cere b r a l em 2, epilepsia, retardo do desenvolvimento neuropsicomotor, demência e trauma de crânio em um caso cada ou outras condições neurológicas em 3. Não havia sintomas neurológicos em 2 casos. Em 15 pacientes (60,0%) havia, além da calcificação dos núcleos da base, outras alterações na TC. Correlação clínica foi o b s e rvada apenas com as outras alterações da TC e não com a calcificação dos núcleos da base, corro b o r a n d o a hipótese de que esta possa ser um achado incidental.PALAVRAS-CHAVE: calcificação intracraniana, núcleos da base, tomografia computadorizada de crânio. Basal ganglia calcification on computed tomography: clinical characteristics in 25 patientsABSTRACT -Twenty-five patients presenting basal ganglia calcification were assessed. This finding comprised 0.68% of all skull CT scan carried out during the period. Two patients were neurologically asymptomatic and 23 presented a variety neurological disorders -headache (7 patients), stroke (5 patients), extrapyramidal syndromes (2 patients), tumor (2 patients), epilepsy (1 patient), mental retardation (1 patient), dementia (1 patient), cranial trauma (1 patient), other neurological conditions (3 patients) -or were asymptomatic f rom the neurological point of view (2 patients). Findings in the CT scan other than the basal ganglia calcification were observed in 15 (60%) patients. There was a clinical-CT scan correlation in these cases but not in those in which the basal ganglia calcification was an isolated finding. This study highlights the fact that basal ganglia calcification is often a nonspecific finding on CT scan and that it may not be possible to establish a clinical-pathological correlation between them.KEY WORDS: computed tomography, intracranial calcification, basal ganglia.As calcificações intracranianas são re l a t i v a m e n t e comuns e podem ser fisiológicas ou associadas a várias doenças do sistema nervoso central (SNC) como infecções, anomalias congênitas, distúrbios metabólicas ou processos tumorais, entre outras, e são visualizadas nos exames de tomografia computadorizada de crâ-nio (TC) como áreas de alta densidade 1,2 .Os núcleos da base podem apresentar calcificações e, na maioria dos casos, a calcificação é pequena, bilateral, usualmente restrita aos globos pálidos, mas pode envolver o putâmen, núcleo caudado, tálamo, núcleos denteados do cerebelo e substancia branca dos hemisférios cerebrais 3-8 .A calcificação dos núcleos da base (CNB) tem sido descrita em associação com várias condições patoló-gicas como os distúrbios da paratireóide, esclero s e t u b e rosa, síndrome de Cockayne, anoxia neonatal, intoxicação por ...