Geriatric epilepsy: Research and clinical directions for the future

Roberson, Erik D.; Hope, Omotola A; Martin, Roy C.; Schmidt, Dieter

doi:10.1016/j.yebeh.2011.04.005

Cited by 17 publications

(19 citation statements)

References 111 publications

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“…Similar findings had been published previously [16,17,19]. Our findings are consistent with already reported verbal memory deterioration following dominant temporal lobe surgery [7,18,19,20].…”

Section: Discussionsupporting

confidence: 93%

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Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Mihaylova¹,

Khan²,

Buchtel³

et al. 2015

MRAJ

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Purpose-Resective epilepsy surgery for temporal lobe epilepsy (TLE) remains underutilized in elderly patients and only few studies report postsurgical seizure and neurocognitive outcomes in this group. The aim of this study was to investigate the tolerability and efficacy of surgery in older epileptics.Methods-We conducted a retrospective analysis of 18 patients aged 55 or older to assess the efficacy and tolerability of the procedure. Mean disease duration was 34 years.Results-Fourteen patients (78%) achieved Engel class I outcome over a mean follow-up period of 4.2 years. Thirteen patients had neuroimaging and histopathology consistent with mesial temporal sclerosis (MTS). We did not find a measurable effect of disease duration on postsurgical outcome. We confirmed Medical Research Archives 2015Issue 2Copyright © 2015, Knowledge Enterprises Incorporated. All rights reserved. 2 that the MRI evidence of MTS can be used as a predictor for postsurgical outcome. Postsurgical neuropsychological evaluation completed in 13 patients between three months and two and a half years post resection showed decline in verbal abilities most significantly in those who had undergone dominant temporal lobe surgery.Discussion/Conclusion-Our results indicate that epilepsy surgery is well tolerated, safe and effective in older patients with refractory TLE. Postsurgical neuropsychological evaluation showed expected decline in verbal abilities in patients who had undergone dominant resection.

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Section: Discussionsupporting

confidence: 93%

“…It is estimated that the number of people aged 65 and older will double between 2010 and 2050. A fourfold increase is expected among persons over the age of 85 [18].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Mihaylova¹,

Khan²,

Buchtel³

et al. 2015

MRAJ

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“…In the present study, in agreement with the literature, practically two thirds of the cases were diagnosed as symptomatic epilepsy, and the etiology identified with greater frequency was cerebrovascular disease in approximately 55% of the cases and in a similar proportion for both age groups 2,6,8,9,15,24 .…”

Section: Epileptic Syndromes Symptomatic Epilepsysupporting

confidence: 92%

“…The following etiologies were also found, equally in agreement with the literature: traumatic brain injury, intracranial arteriovenous malformation and degenerative disease 6,8,24 . The etiology was neurocysticercosis in two cases, with viable cysts visible in the neuroimaging exam.…”

Section: Epileptic Syndromes Symptomatic Epilepsysupporting

confidence: 89%

Epilepsy with onset at over 50 years of age: clinical and electroencephalographic characteristics

Fonseca

Junior

Pazetto

2012

Arq. Neuro-Psiquiatr.

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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...

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“…However, the neocortical layer of most severe neuronal loss and in adult tauopathies is layer 2 [34] and the phosphorylated tau expression in all of our infantile cases of HME was also in the superficial laminae of the cortex, showing a similar gradient within the cortex. Tau over-expression is not specific to HME in paediatric brain tissue, but the only other malformations which share this feature, to our knowledge, are tuberous sclerosis and focal cortical dysplasia type IIb, with balloon cells and dysplastic neurons, which also share the same property of mTOR activation [40,49]. Tau over-expression is also reported many years following traumatic contusions of the brain [22].…”

Section: Discussionmentioning

confidence: 76%

Original article Hemimegalencephaly: foetal tauopathy with mTOR hyperactivation and neuronal lipidosis

Sarnat¹,

Flores‐Sarnat²,

Crino³

et al. 2012

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Geriatric epilepsy: Research and clinical directions for the future

Cited by 17 publications

References 111 publications

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Epilepsy with onset at over 50 years of age: clinical and electroencephalographic characteristics

Original article Hemimegalencephaly: foetal tauopathy with mTOR hyperactivation and neuronal lipidosis

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