Non-epileptic seizures of the elderly

Abstract

NES are a frequent problem in elderly patients referred to a comprehensive epilepsy center. In contrast to a younger control group, physiological and psychogenic NES are equally frequent in the elderly. Loss of responsiveness was seen in only 20% of patients with psychogenic NES. Although most of the patients did not have any evidence for epilepsy, more than two thirds of these patients had been placed on anticonvulsive drugs.

Demographic and historical backgrounds of the elderly with nonepileptic seizures: A comparative study

“…Of all NES patients 10.9% were over 55 years of age, similar to the 9.6% reported in an earlier study. [17] Of the elderly patients admistted to our EMU, 18% were diagnosed to have pure NES, a percentage similar to that reported by McBride et al [7] and somewhat lower than the 44% reported by Kellinghaus et al [8] It can be concluded that NES are not uncommon among elderly patients. We found some differences between younger and older NES patients.…”

Depression and symptoms affect quality of life in psychogenic nonepileptic seizures

“…25 PNES does occur in the elderly, however, studies reporting outcome measures in the elderly are limited. [26][27][28] Another potential limitation is that the SCL-90 was used as a surrogate for patient symptoms, instead of the AEP used in the Gilliam study. 11 We elected to use the SCL-90 because not all patients with PNES were taking AEDs, the symptoms of which the AEP scale targets specifically.…”

Elders with Epilepsy

“…Findings from several series have shown that prolonged EEG video monitoring leads to a definitive diagnosis of seizures versus nonepileptic events in most elderly patients having a mean length of stay of 3 to 4 days [13,25]. Studies [13,25,26] have shown more than half of patients over 60 who were monitored with prolonged inpatient video EEG ultimately were diagnosed with nonepileptic events (such as pseudo-seizures often from conversion disorder, cardiac events, TIA, syncope, movement disorders, and sleep disorders). This occurrence is important because most elderly patients undergoing video EEG monitoring who ultimately were diagnosed with nonepileptic events were taking anticonvulsant medications on admission, putting them at unnecessary risk for side effects and drug interactions [15].…”

“…This occurrence is important because most elderly patients undergoing video EEG monitoring who ultimately were diagnosed with nonepileptic events were taking anticonvulsant medications on admission, putting them at unnecessary risk for side effects and drug interactions [15]. Also, 25% of elderly patients who have nonepileptic events (as is seen in younger patients who undergo prolonged video EEG monitoring) experience epileptic events [26], emphasizing the importance of recognizing the frequency of this cooccurrence of nonepileptic and epileptic events in these same patients for appropriate therapeutic interventions for each.…”