Newly Onset Seizures in the Elderly: A Hospital-based Study.
- Author:
Im Seok KOH
1
;
Hong Ki SONG
;
Jin Hyuck KIM
;
Hyoung Cheol KIM
;
Sung Hee HWANG
;
Ki Han KWON
;
Jae Chon BAE
;
Byung Chul LEE
Author Information
1. Department of Neurology, Hallym University College of Medicine.
- Publication Type:Original Article
- Keywords:
Seizure;
Elderly;
Etiology Manuscript received November 17
- MeSH:
Aged*;
Electroencephalography;
Epilepsy;
Female;
Hemorrhage;
Hospitalization;
Humans;
Hypoxia, Brain;
Incidence;
Infarction;
Korea;
Mortality;
Seizures*;
Status Epilepticus;
Stroke
- From:Journal of the Korean Neurological Association
2000;18(2):151-155
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Increasing incidences of epilepsy in the elderly are well-known. However, the causes of newly onset seizures in the elderly have rarely been described in Korea. METHODS: We selected 160 cases of individuals who had their first seizure at over the age of 60 (male : female = 1.5 : 1 ; mean age : 69.1 years), who were admitted to Hallym University Hospital from July 1, 1994 to June 31, 1998. We analyzed the etiology, type of seizures, EEG, neuro-imag-ing, morbidity and mortality of the patients. RESULTS: The etiologies of seizures were remote symptomatic in 87 (54.3%), acute symptomatic in 38 (23.8%), progressive encephalopathy in 21 (13.1%), and idiopathic in 14 (8.8%). Status epilepticus occurred in 34 cases, including 8 cases of multifocal myoclonic status after hypoxic brain damage. The most common single cause of seizure was old stroke (35%, infarction in 41 and hemorrhage in 15 cases). Partial seizure was more common in patients with remote symptomatic than with other causes. Newly developed neurological deficits were present in 30 of the 151 who survived, including 15 acute symptomatic, 9 remote symptomatic, and 6 pro-gressive encephalopathy cases. Morbidity and mortality were highest in the acute symptomatic group (P<0.05) and tend to be low in the idiopathic group. CONCLUSIONS: We conclude that newly onset seizures in the elderly requiring hospitalization occur mainly with acute and remote symptomatic neurological insults. Acute symptomatic neurological insults are associated with a significant morbidity and mortality, while the morbidity is low in the absence of any asso-ciated neurological insults.
