Comparison of new-onset and persistent epilepsy in the elderly

Abstract

Epidemiological studies show that the incidence of epilepsy is significantly higher in the elderly than in any other age groups, and the prevalence of epilepsy increases rapidly with age except in the very young population. 1 The high prevalence of epilepsy in the elderly may result from the more frequent epilepsy-associated neurological diseases such as stroke and traumatic brain injury, 2 but the improved survival of previously diagnosed epilepsy patients can affect the high prevalence in the elderly population because life expectancy did not decrease significantly in adult epilepsy patients with improvements in general medical care. 3 Although there have been a number of studies on elderly patients with epilepsy, most studies included only patients with new-onset disease and excluded patients who began to suffer from epilepsy before the age of 65 and aged. 4,5 Only several studies compared clinical features of epilepsy in the elderly between the earlier and later onset groups with psychosocial considerations. 7,8 We hypothesized that elderly patients with persistent epilepsy may have different clinical features than those with new-onset disease, and we compared the characteristics of new-onset and persistent epilepsy in the elderly in various aspects, including the results of diagnostic evaluations, comorbidity, treatment, and prognosis. AbstractBackground: Previous studies on elderly epilepsy included only patients with newonset disease, but there are many patients who developed epilepsy earlier and aged. Aim:We compared the characteristics of new-onset and persistent epilepsy in the elderly. Methods:We performed a 10-year retrospective analysis of elderly patients with epilepsy divided into two groups according to the onset of seizure: new-onset epilepsy (onset age ≥65) and persistent epilepsy (onset age<65). Results: Nearly half (78/172, 45.3%) of patients in the new-onset group presented as status epilepticus, and one-fourth of these (19/78, 24.4%) died during the initial treatment for status epilepticus. Patients in the new-onset epilepsy group presented more frequently as status epilepticus (59/153 vs 12/78, P < 0.001) and had a past history of status epilepticus (63/153 vs 20/78, P = 0.02). History of stroke (81/153 vs 30/78, P = 0.04), hypertension (83/153 vs 29/78, P = 0.01), and dyslipidemia (53/153 vs 17/78, P = 0.05) was more common in the new-onset group, but patients in the persistent group used more antiepileptic drugs (AEDs; P = 0.036) and total AED drug loads (P = 0.028). Conclusions:Our study shows that new-onset epilepsy has a higher incidence of status epilepticus and more stroke-related risk factors but may require fewer AEDs for epilepsy control. K E Y W O R D Selderly, epilepsy, status epilepticus in the new-onset group. Similar results were also observed in one previous study, 7 and differences in underlying pathological changes between the two groups could have affected this finding. 13 Patients in the new-onset epilepsy group had higher chances of stroke, hypertension, and dyslipidemi...

A Case of Myoclonic Epilepsy Presenting with Status Epilepticus in an Elderly Male Patient

“…The mortality of status epilepticus is known to be highest in the oldest, and it has been shown that new-onset epilepsy has a higher incidence of status epilepticus in the elderly population. 18 Although its incidence has not been investigated in the subgroup of myoclonic status epilepticus, a mortality rate of approximately 50% in has been reported in overall patients with status epilepticus those over 80 years of age. 19 Hence, we also suggest that in presentations of atypical movement disorders in elderly patients, performing EEG may be a vital tool for the proper diagnosis and timely interventions.…”

“…The mortality of status epilepticus is known to be highest in the oldest, and it has been shown that new-onset epilepsy has a higher incidence of status epilepticus in the elderly population. 18 Although its incidence has not been investigated in the subgroup of myoclonic status…”