RISK FACTORS OF EPILEPSY IN ELDERLY POPULATION: RETROSPECTIVE OBSERVATIONAL STUDY
Keywords:
epilepsy, elderly, stroke, seizure, risk factors of epilepsyAbstract
One of the 3rd most frequent neurological condition to be found in elderly is epilepsy. Yet there is an ongoing debate regarding the differentiation among epilepsy and several seizure disorders to be found in elderly patients. In this regard, research findings implied a highly associated nexus between stroke and early seizures and epilepsy at elderly patients.
Main objective of this study is to determine the prevalence and the etiology of epilepsy in elderly diagnosed in our clinic.Included are data from all patients who were diagnosed with epilepsy from January 1, 2015 to December 31, 2019 in University Clinic of neurology, Skopje. A systematic search of the HIS identified all subjects with a diagnosis code for Epilepsy. Analyzed were the most common risk factors that appear as the main causes of epilepsy, the type of seizures and AEDs that the patients were treated with. Statistical software was used for statistical analysis. 93 patients were diagnosed with Epilepsy, 28 females and 65 males. 48 patients diagnosed with Epilepsy aged 60 to 69, 14 patients aged 70 to 79 years, 12 patients aged 80 to 89, and 1 patient over 90 years old. The most common etiology for the occurrence of epilepsy is of unknown cause, 34 patients, 36.6%. The second common risk for the development of epilepsy is stroke, 26 patients, 28%. The third cause is brain tumor, 25 patients, 26.9%, followed by 7 patients with dementia and Parkinson's disease and one with cerebral palsy. The most common types of epileptic seizures among subjects are focal seizures. The most common type of AEDs that the patients used was Carbamazepine. There is a differentiation regarding the common semiology of seizures in elderly patients and younger patients. Therefore, a need for a proper chosen AEDs suitable for the elderly patients should be taken into consideration. Reported is strong association between epilepsy and stroke, brain tumors and dementia. In our patients the most frequent etiology of epilepsy is to be the cryptogenic.
References
Annegers JF, Hauser WA, Lee JR, Rocca WA. (1995): Incidence of acute symptomatic Seizures in Rochester, Minnesota: 1935–1984. Epilepsia ; 36:327–33.
Beghi E, Ciccone A (1993): First Seizure Trial Group Recurrence after a first unprovoked Seizure. Is it still a controversial issue? Seizure; 2:5–10.
Berg AT, Shinnar S (1991): The risk of Seizure recurrence following a first unprovoked Seizure: a quantitative review. Neurology; 41:965–72.
Brodie MJ, Elder AT, Kwan P (2009): Epilepsy in later life. Lancet Neurol. 2009; 8:1019–30.
Castilla-Guerra L, del Carmen Fernández-Moreno M, López-Chozas JM, Fernández-Bolaños R. (2006): Electrolytes disturbances and Seizures. Epilepsia; 47:1990–8.
Cheng JY, French JA (2018): Intelligent use of antiepileptic drugs is beneficial to patients. Curr Opin Neurol; 31:169–75.
Choi H, Pack A, Elkind MS, Longstreth WT, Jr, Ton TG, Onchiri F. (2017): Predictors of incident epilepsy in older adults: the cardiovascular health study. Neurology. 88:870–7
Cloyd J, Hauser W, Towne A (2006): Epidemiological and medical aspects of epilepsy in the elderly. Epilepsy Res;66: S39–48.
Faught E, Richman J, Martin R, (2012): Incidence and prevalence of epilepsy among older U.S. Medicare beneficiaries. Neurology.; 78:448–53.
Gibosh S, Jehi LE (2014): New-onset epilepsy in the elderly:challeges for the internist. Clev Clin J Med.; 81:490–8.
Guekht A, Bornstein NM (2012): Seizure after stroke. Handb Clin Neurol; 108:569–83.
Hampel KG, Thijs RD, Elger CE, Surges R. (2017): Recurrence risk of ictal asystole in epilepsy. Neurology. 2017; 89:785–91.
Hart YM, Sander JW, Johhnson AL, Shorvon SD. (1990): National General practice study of epilepsy: recurrence after a first Seizure. Lancet; 336:1271–4.
Hauser WA, Annegers JF, Kurland LT. (1993): Incidence of epilepsy and unprovoked Seizures in Rochester Minnesota: 1935–1984. Epilepsia. 34:453–68
Hauser WA, Rich SS, Annegers JF, Anderson VE. (1990): Seizure recurrence after a 1st unprovoked seizure: an extended follow-up. Neurology. 40:1163–70.
Johnston A, Smith PE (2010): Epilepsy in the elderly. Expert Rev Neurother; 10:1899–910.
Lee A. (2010): Retrospective study of Seizure-related injuries in older people: a 10-yaer observation. Epilepsy Behav. 2010; 19:441–4.
Lee SK (2019): Epilepsy in the Elderly: Treatment and Consideration of Comorbid Diseases. J Epilepsy Res. 2019 Jun 30;9(1):27-35.
Liu S, Yu W, Lü Y (2006): The causes of new-onset epilepsy and seizures in the elderly. Neuropsychiatr Dis Teat. 2006; 12:1425–34.
Poza JJ. (2007): Management of epilepsy in the elderly. Neuropsychiatr Dis Treat. 2007; 3:723–8.
Waterhouse E, Towne A.(2005): Seizures in the elderly: nuances in presentation and treatment. Clev Clin J Med. 2005;72(Suppl 3): S26–37.
Zack MM, Kobau R. (2017): National and state estimate of the numbers of adults and children with active epilepsy - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017; 66:821–25.
Zhao Y, Li X, Zhang K, Tong T, Cui R. (2018): The progress of epilepsy after stroke. Curr Neurophamacol.2018;16:71–8