Status epilepticus in the elderly: epidemiology, clinical aspects and treatment

Assis, Telma; Costa, Gersonita; Bacellar, Aroldo; Orsini, Marco; Nascimento, Osvaldo J. M.

doi:10.4081/ni.2012.e17

Cited by 20 publications

(24 citation statements)

References 59 publications

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“…SE incidences and mortality rate increased slightly over this period ( Table 1). The incidence rates in this study were lower than previous reports from the Western countries [4][5][6][7][8][9][10]. In 2012, the incidence rate of SE in the Thai elderly population was 8.78/100,000 population, while a study from California found an incidence rate there of 22.3/100,000 population in a generalized tonic clonic SE in the elderly aged 75 years and older [10].…”

Section: Discussioncontrasting

confidence: 83%

“…Several studies have shown that the incidences of SE in people over 60 were higher than in the general population [4][5][6][7]. The incidence rate of SE in the elderly (over 60 years old) was 39.2/100,000 population and higher than that in the younger age group (20-59 years) of 14.7/ 100,000 population [5].…”

Section: Introductionmentioning

confidence: 99%

“…Status epilepticus (SE), a serious complication of epilepsy and a major public health problem [3], may also be increasing in the elderly similar to epilepsy. SE in the elderly may be more intractable and have high morbidity and mortality compared with the general population [4].…”

Section: Introductionmentioning

confidence: 99%

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Status epilepticus in the elderly patients: A national data study in Thailand

Tiamkao

Pranboon

Thepsuthammarat

et al. 2017

Journal of the Neurological Sciences

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Section: Discussioncontrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Status epilepticus in the elderly patients: A national data study in Thailand

Tiamkao

Pranboon

Thepsuthammarat

et al. 2017

Journal of the Neurological Sciences

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“…Higher mortality rate, was found in those patients who presented SE, 78% (7 patients). The high mortality rate ascertained in our study is similar to that described by most authors and also shows a strong dependence on etiological factors and age 24,25 . The data from some studies showed that SE was associated with a mortality rate ranging from 38% to 50% in patients older than 80 years of age and it may reach 100% in patients with anoxia 26,27 .…”

Section: Discussionsupporting

confidence: 77%

Mortality predictors of epilepsy and epileptic seizures among hospitalized elderly

Assis

Bacellar

Costa

et al. 2015

Arq. Neuro-Psiquiatr.

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People with epilepsy and epileptic seizures are at an increased risk of dying when compared to the general population mostly in special groups such as those with acute symptomatic seizures or status epilepticus (SE). Patients over 75 years have higher incidence of acute symptomatic seizures, epilepsy and SE compared to other age groups 1 . Acute symptomatic seizures represent 40% of all seizures and 50%-70% of SE and are more commonly seen at extreme ages, with the highest incidence rates seen in children below 1 year of age and adults 60 years and above 2,3 .Notwithstanding its high incidence, epilepsy in old-aged people often goes unrecognized and neglected. In contrast, the prevalence is relatively low possibly because of the increased mortality rates for old-aged people due to its etiology 4 . Studies reported that neurological disorders such as cerebrovascular disease and neoplasias, contribute to excess mortality in patients with epilepsy 5 . Studies on mortality in epilepsy have been reported from a few developed countries. In high-income countries, the mortality rate in elders with epilepsy is two to three times higher than in the general population, and the highest excess mortality is ABSTRACT Epilepsy and epileptic seizures are common brain disorders in the elderly and are associated with increased mortality that may be ascribed to the underlying disease or epilepsy-related causes. Objective: To describe mortality predictors of epilepsy and epileptic seizures in elderly inpatients. Method: Retrospective analysis was performed on hospitalized elderly who had epilepsy or epileptic seizures, from January 2009 to December 2010. One hundred and twenty patients were enrolled. Results: The most common etiology was ischemic stroke (37%), followed by neoplasias (13%), hemorrhagic stroke (12%), dementias (11.4%) and metabolic disturbances (5.5%). In a univariate analysis, disease duration (p = 0.04), status epilepticus (p < 0.001) and metabolic etiology (p = 0.005) were associated with mortality. However after adjustment by logistic regression, only status epilepticus remained an independent predictor of death (odds ratio = 13; 95%CI = 2.3 to 72; p = 0.004). Conclusion: In this study status epilepticus was an independent risk factor for death during hospitalization.Keywords: elderly, epilepsy, epileptic seizures, mortality, status epilepticus. RESUMOEpilepsia e crises epilépticas são transtornos cerebrais comuns em idosos e estão associadas com uma taxa de mortalidade elevada que pode ser atribuída à etiologia ou a causas relacionadas à epilepsia. Objetivo: Descrever preditores de mortalidade em pacientes idosos internados com epilepsia e crise epiléptica. Método: Estudo retrospectivo, envolvendo idosos hospitalizados, de 60 anos ou mais, que foram admitidos de janeiro de 2009 a dezembro de 2010 por terem apresentado epilepsia e crises epilépticas durante a hospitalização. Cento e vinte pacientes foram incluídos no estudo. Resultados: A etiologia mais comum foi o acidente vascular cerebral isquêmico (37%), segu...

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“…It is the third most frequent neurological disorder in the elderly following stroke and dementia and even more relevant because, in this growing age group, it is often neglected 2 . In Brazil and in developed and some developing countries the demography profile is changing with increasing life expectation, thus the elderly comprise the fastest growing group of the population 3 . Currently 25 to 30% of new onset epilepsy is diagnosed in elders 4,5 .…”

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confidence: 99%

Antiepileptic drugs patterns in elderly inpatients in a Brazilian tertiary center, Salvador, Brazil

Assis

Nascimento

Costa

et al. 2014

Arq. Neuro-Psiquiatr.

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Epilepsy is very prevalent among elderly inpatients and treatment is far from ideal. Objective: To analyze prescribing patterns of antiepileptic drugs (AEDs) for hospitalized elderly with epilepsy, their relations with comorbidities and comedications. Method: We assessed prescription regimen of elderly patients that were under AED use for treatment of epileptic seizures, during hospitalization. One hundred and nine patients were enrolled. AED regimen was categorized into two groups: Group 1 defined as appropriate (carbamazepine, oxcarbazepine, valproic acid, gabapentin, clobazan and lamotrigine) and Group 2 as inappropriate (phenytoin and phenobarbital). Results: We found 73.4% of patients used inappropriate AEDs (p,0.001). Monotherapy was prescribed for 71.6% of patients. The most common comorbidity was hypertension. Potentially proconvulsant drugs as comedications were used for nearly half of patients. Conclusion: Inappropriate AED therapy was commonly prescribed regimen for elderly inpatients. Some recommendations are discussed for a better care of elderly inpatients with epilepsy.Keywords: antiepileptic drugs, elderly, epilepsy, epileptic seizures. RESUMOEpilepsia é frequente entre idosos hospitalizados e o tratamento costuma ser aquém do ideal. Objetivo: Analisar os padrões de prescrição de drogas antiepilépticas para idosos hospitalizados com epilepsia, bem como sua relação com comorbidades e comedicações. Método: Revisamos os prontuários de pacientes idosos internados com diagnóstico de epilepsia e que estavam em uso de droga antiepiléptica (DAE) durante o período de hospitalização. Cento e nove pacientes foram incluídos no estudo. O regime de DAE foi categorizado em dois grupos: Grupo 1, definido como apropriado (carbamazepina, oxcarbazepina, ácido valpróico, gabapentina, clobazam e lamotrigina) e Grupo 2, como inapropriado (fenitoína e fenobarbital). Resultados: 73,4% dos pacientes usaram DAE inapropriadas (p,0,001). Regime de monoterapia foi usado por 71,6% dos pacientes. Hipertensão arterial foi a comorbidade mais frequente. Medicações concomitantes potencialmente proconvulsivantes foram usadas por quase metade desta população. Conclusão: Regime de droga antiepiléptica inapropriada foi o mais utilizado em pacientes idosos internados. São discutidas algumas recomendações para melhor cuidado ao paciente idoso hospitalizado com epilepsia.Palavras-chave: drogas antiepilépticas, idosos, epilepsia, crises epilépticas.

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Status epilepticus in the elderly: epidemiology, clinical aspects and treatment

Cited by 20 publications

References 59 publications

Status epilepticus in the elderly patients: A national data study in Thailand

Status epilepticus in the elderly patients: A national data study in Thailand

Mortality predictors of epilepsy and epileptic seizures among hospitalized elderly

Antiepileptic drugs patterns in elderly inpatients in a Brazilian tertiary center, Salvador, Brazil

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