S. Gopi, Sudheer Chowdary
BACKGROUND The annual incidence is 85 per 1,00,000 for people aged 65-69 years and 135 per 1,00,000 for those aged over 80 years. Epilepsy in older patients poses several additional problems for the provision of services compared with the rest of the population as diagnostic difficulties and polypharmacy. The aim of the study is to- 1. Know the various causes of seizures, clinical profile and correlation between neurological imaging and VEEG characteristics. 2. Know the differences between the aetiologies of seizures in young age and elderly >65 years. MATERIALS AND METHODS This was a prospective, hospital-based case control study conducted on 75 patients older than 65 years with new-onset seizures at KGH Neurology OP and IP Services from September 2014 - November 2016 using EEG, MRI or CT brain and relevant laboratory tests. RESULTS 75 patients (46 males, 29 females) with a mean age of 73.72 ± 8.72 years were enrolled in the study. Overall, the seizures were classified as generalised onset in 7 (9.4%), focal onset in 52 (70.1%) and uncertain onset in 15 (20.5%) patients. The aetiology was acute symptomatic in 29 (39.2%), remote symptomatic in 24 (31.7%), progressive symptomatic in 14 (19.1%) and unknown in 8 (10.1%) patients. CONCLUSION Most of the new-onset seizures in our elderly patients were focal onset as a consequence of vascular brain lesion. The recurrence was high. The major risk factors for recurrent seizures were acute, remote and progressive symptomatic aetiologies, epileptiform discharges and nonspecific abnormalities on EEG. Elderly patients maybe at a higher risk of recurrence following an initial stroke than younger people.
