Epilepsy in the Elderly: Dilemma of Diagnosis

[摘要] Background: Epilepsy is common among old ages. Seizure semiology and EEG changes in elderly patients are often not classic and obvious as younger age. Objective: To report the crucial roles of careful history taking, clinical semiology, EEG changes and MRI findings in determination the causes of epilepsy in old age people. Methods: Forty four patients, their ages ranged from 65 to 88 years (28 males and 16 females) were enrolled between Jan-2008 and Dec-2009 at Mansoura University Hospitals. Independent neurological examination, EEG record, brain CT and MRI examinations were performed for all patients. Results: The frequency of seizures was, 47.7%, 38.6%, 22.7% and 50%among patients with diabetic, hypertensive, cardiac history and over the age of 85 years consecutively. Complex partial seizures without aura were reported in 45.5%. Initial EEG was normal in 27.2% that became 18% with repeated EEG recording for the same patients. Focal epiletiform discharges with secondary generalization were reported in 31.3%. Cortical infarction, hemorrhagic infarction, cerebral hemorrhage, metastasis, meningioma, subdural hematoma were reported in 18.1%, 6.8% and 6.8%, 11.3%, 4.5%, and 6.8%consecutively. Meningitis and meningoencephalitis were reported in 4.6%. Conclusion: Full history, clinical examination, repeated long term EEG and neuroimaging studies are crucial tools for accurate and early diagnosis of elderly epilepsy. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(1): 25-30]

[学科分类] 精神健康和精神病学