Objective: To evaluate the etiology and the clinical features of eldery outpatients with epilepsy referred to our department.
Materials and Methods: We studied 30 patients in which epilepsy has started after the age of 60. Variables considered were starting age, etiology, seizure type and antiepileptic tretment. The standard diagnostic tools were applied: routine laboratory blood analysis, EEG, sleep EEG and/or EEG after sleep deprivation, CT scan and/or MRI, additional methods were indicated.
Results: The mean age of the patients were 66,7 years, with no significant diferences in sex distribution (17 males and 13 females). Stroke was leading cause of new onset epilepsy in eldery, which accounts for 63,3% (19 patients). Tumors were found in 3 patients (10%), 2 patients suffered neurodegenerative disorders (6,6%), 2 were alchohol abusers (6,6%) and in 13,3% the etiology remained undeterminated. Considering the seizure type: 26,7% experianced complex partial seizures, 23,3% focal motor seizures, 6,67% focal sensory seizures and 40% generalized seizures (more than half of which have clinical or electrical evidence of focal onset). In one patient epilepsy has started with focal motor status. Antiepileptic drugs which have been used, were: carbamazepine in 63,3%, phenobarbiton in 16,7%, valproic acid in 13,3% , and phenytoin 6,66%.
Conclusion: In our patients stroke was the most frequent cause of epilepsy in eldery, semiology of the seizures varied in the wide range from simple focal to generalized tonic-clonic seizures, and carbamazepine was dominate antiepileptic drug used. In our opinion, as a third most frequent neurological problem in eldery, epilepsy requires accurate diagnosis and identification of the underlying etiology, as well as careful treatment and monitoring.
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