Complex partial status epilepticus in the elderly: clinical features and causes of misdiagnosis
10.3760/cma.j.issn.1671-8925.2009.07.008
- VernacularTitle:中老年复杂部分性发作癫痫持续状态的临床特征及误诊分析
- Author:
Xiao-Rong LIU
1
;
Xin-Wang SONG
;
Hao-Hui CHANG
;
Yu-Liang WANG
;
Xin ZOU
Author Information
1. 广州医学院附属第二医院
- Keywords:
Complex partial status epilepticus;
Temporal lobe epilepsy;
Frontal lobe epilepsy;
Electroencephalography
- From:
Chinese Journal of Neuromedicine
2009;8(7):678-681
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features and causes of misdiagnosis of complex partial status epilepticus (CPSE) in the elderly. Methods The clinical data of elderly patients with CPSE admitted in our department between January and December, 2008 with previous misdiagnosis were reviewed. The diagnosis of CPSE was established according to the diagnostic criteria of the International League Against Epilepsy (ILAE). All the patients underwent video-EEG examination, head magnetic resonance imaging (MRI), and routine biochemical examination, and were followed up for at least 3 months. Results Seven female CPSE patients were involved in this analysis including 2 with frontal lobe epilepsy and 5 with temporal lobe epilepsy. The conditions were misdiagnosed as a variety of diseases including Alzheimer's disease, cerebral infarction, coronary heart disease, encephalitis, hysterism, and schizophrenia, and the duration of the misdiagnoses ranged from 2 days to 40 years. Video-EEG showed slow background, continuous interictal discharges or high-voltage slow waves in the temporal or frontal lobe, or ictal discharges of complex partial seizures. After treatment with antiepileptic medications, 3 patients were free of epileptic episodes within 3 months, 3 still remained in complex partial status, and 1 had repeated CPSE. Conclusions Complex symptoms, atypical EEG, co-morbidity and social factors all contribute to misdiagnosis of CPSE in the elderly. Suspected patients should undergo video-EEG examination for a definite diagnosis as early as possible.
