The clinical analysis of senile epilepsy_Journal of Epilepsy

Authors：

 ZHOUPan ^1,2 ,  CHENYangmei ¹

1. Department of Neurology, the Second Affiliated Hospital Of Chongqing Medical University, Chongqing 400010, China;
2. Department Of Neurology, the People's Hospital Of Kaizhou District, Chongqing 400010, China;

Corresponding?author：

CHENYangmei, Email: chenym1997@sina.com

Keywords：

Senile epilepsy; The type of seizures; Etiology; Therapy; Prognosis

DOI：

10.7507/2096-0247.20160087

Video：

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Objective To investigate the classification of seizures, etiology,EEG examination, treatment and prognosis of senile epilepsy. Methods The clinical data of 92 senile epileptsy patients in the Second Affiliated Hospital Of Chongqing Medical University from January 2012 to September 2015 were retrospectively analyzed. Results From the selected sample,15 cases suffered from SPS(16.3%),22 cases suffered from CPS(23.9%),40 cases suffered from GTCS(43.5%),4 cases suffered from partial seizures with secondary generalization(4.3%),11 cases suffered from both partial seizures and generalized seizures(12.0%).The common causes include cerebrovascular disease (57.6%),intracranial tumors (10.9%), degenerative brain diseases (7.6%) and so on.The abnormal ratio of REEG and AEEG was 87.1% and 91.7% respectively.The ratio of typical epileptiform activity in the REEG and AEEG was 22.6% and 70.8% respectively.82 cases(89.1%) were treated with AED,but only 69 cases had been taking orally AED among the patients treated with AED.57 cases(82.6%) were on monotherapy.55 cases (67.1%) were controlled effectively with drug treatment,11 cases (13.4%) were ineffective and 16 patients (19.5%) died. Advanced age was the important cause of death. Age was positively correlated with the fatality rate.9 cases(10.9%) appeared side effect,the frequency of sleepiness was the highest among all the adverse reactions. Conclusion The majority of senile epilepsy suffer from symptomatic epilepsy.The main cause is cerebrovascular disease,the generalized tonic-clonic seizures constituted a high proprotion in the sample.The ratio of typical epileptic discharge in the REEG was low from senile patients with epilepsy,we recommend the AEEG examination in the senile patients suspected with epilepsy. AED has excellent therapeutic effects in senile epileptics,and a few patients appeared light adverse reactions.

Citation： ZHOUPan, CHENYangmei. The clinical analysis of senile epilepsy. Journal of Epilepsy, 2016, 2(6): 494-498. doi: 10.7507/2096-0247.20160087 Copy

1.	Tanaka A, Akamatsu N, Shouzaki T, et al. Clinical characteristics and treatment responses in new-onset epilepsy in the elderly. Seizure, 2013, 22(9):772-775.
2.	Leppik IE,Birnbaum AK. Epilepsy in the elderly, Ann NY Acad Sci, 2010, 1184(1):208-224.
3.	吳遜, 林慶. 癲癇和發作性疾病. 北京:人民軍醫出版社, 2001:208.
4.	Commission on Classification and Terminology of International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 1981, 22(3):189-501.
5.	馬宇. 老年癲癇患者常見病因與臨床特征分析. 中國實用神經疾病雜志, 2015, 18(2):27-29.
6.	Stefan H. Epilepsy in the elderly:diagnostic and therapeutic problems. MMW Fortschr Med, 2006, 2(4):88-90.
7.	Elizabeth AM,William DF.Status epilepticus in the elderly:differential diagnosis and treatment.Neuropsychiatric Dis Treat,2011,7(3):161-166.
8.	Huang Y, Guo J, Wang Q, et al. MicroRNA-132 silencing decreases the spontaneous recurrent seizures. Int J Clin Exp Med, 2014, 7(2):1639-1649.
9.	Rowan AJ, Ramsay RE, Collins JF, et al. New onset geriatric epilepsy:a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology, 2005, 64(4):1868-1873.
10.	Cloyd J, Hauser W, Towne A, et al. Epidemiological and medical aspects of epilepsy in the elderly. Epilepsy Research, 2006, 68(Suppl. 1):39-48.
11.	Rishi VA, Peter P. Epileptic fits and epilepsy in the elderly:General refections, specitic issues and therapeutic implications. Clin Neurol Neurosurg, 2007, 109(9):727-743.
12.	Benbir G, Ince B, Dozluolcay M. The epidemiology of poststroke epilepsia according to stroke subtypes. Acta Neurol Scand, 2006, 114(11):8-12.
13.	Bladin CF, Alexandrov AV, Bellavance A, et al. Seizures after stroke:a prospective multicenter study. Arch Neurol, 2000, 57(3):1617-1622.
14.	Lamy C, Domigo V, Semah F, et al. Early and late seizures after cryptogenic ischemic stroke in young adults. Neurology, 2003, 60(1):400-404.
15.	Silverman IE, Restrepo L, Mathews GC. Poststroke seizures. Arch Neurol, 2002, 59(11):195-201.
16.	Grewal J,Grewal HK,Forman AD. Seizures and epilepsy in cancer. Etiologies,evaluation and management.Curr Oncol Rep,2008,10(7):63-71.
17.	沈鼎烈, 王學峰. 臨床癲癇學. 上海:科學技術出版社, 2007:360.
18.	Amatniek JC.Hausor WA,DelCastillo-Castaneda C,et al. Incidence and predictors of soizures in patients with Alzheimer's disease.Epilepsia,2006, 47(7):867-872.
19.	Mendez MF, Lim GTH. Seizures in elderly patients with dementia:epidemiology and management. Drugs Aging, 2003, 20(11):791-803.
20.	de la Courtte A,Breteler MM,Meinardi H, et al. Prevalence of epilepsy in the eldedy:the Rotterdam study.Epilepsia,1996,37(1):141-147.
21.	Craig I,Tallis R.General practice nmnagement of adult-onset epilepsy analysed.Care Elderly,1991,3(2):69-72.
22.	Watson P, Conroy A, Moran G, et al. Retrospective study of sensitivity and specificity of EEG in the elderly compared with younger age groups. Epilepsy Behav, 2012, 25(6):408-411.
23.	Werhahn KJ, Trinka E, Dobesberger J, et al. A randomized, double-blind comparison of antiepileptic drug treatment in the elderly with new-onset focal epilepsy. Epilepsia, 2015, 56(3):450-459.
24.	Papazian O, Canizales E, Alfonso I, et al. Reversible dementia and apparent brain atrophy during valproate therapy. Ann Neurol, 1995,38(6):687-691.
25.	Leppik IE. Treatment of epilepsy in the elderly. Curr Treat Options in Neurol, 2008,10(8):239-215.

1. Tanaka A, Akamatsu N, Shouzaki T, et al. Clinical characteristics and treatment responses in new-onset epilepsy in the elderly. Seizure, 2013, 22(9):772-775.
2. Leppik IE,Birnbaum AK. Epilepsy in the elderly, Ann NY Acad Sci, 2010, 1184(1):208-224.
3. 吳遜, 林慶. 癲癇和發作性疾病. 北京:人民軍醫出版社, 2001:208.
4. Commission on Classification and Terminology of International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 1981, 22(3):189-501.
5. 馬宇. 老年癲癇患者常見病因與臨床特征分析. 中國實用神經疾病雜志, 2015, 18(2):27-29.
6. Stefan H. Epilepsy in the elderly:diagnostic and therapeutic problems. MMW Fortschr Med, 2006, 2(4):88-90.
7. Elizabeth AM,William DF.Status epilepticus in the elderly:differential diagnosis and treatment.Neuropsychiatric Dis Treat,2011,7(3):161-166.
8. Huang Y, Guo J, Wang Q, et al. MicroRNA-132 silencing decreases the spontaneous recurrent seizures. Int J Clin Exp Med, 2014, 7(2):1639-1649.
9. Rowan AJ, Ramsay RE, Collins JF, et al. New onset geriatric epilepsy:a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology, 2005, 64(4):1868-1873.
10. Cloyd J, Hauser W, Towne A, et al. Epidemiological and medical aspects of epilepsy in the elderly. Epilepsy Research, 2006, 68(Suppl. 1):39-48.
11. Rishi VA, Peter P. Epileptic fits and epilepsy in the elderly:General refections, specitic issues and therapeutic implications. Clin Neurol Neurosurg, 2007, 109(9):727-743.
12. Benbir G, Ince B, Dozluolcay M. The epidemiology of poststroke epilepsia according to stroke subtypes. Acta Neurol Scand, 2006, 114(11):8-12.
13. Bladin CF, Alexandrov AV, Bellavance A, et al. Seizures after stroke:a prospective multicenter study. Arch Neurol, 2000, 57(3):1617-1622.
14. Lamy C, Domigo V, Semah F, et al. Early and late seizures after cryptogenic ischemic stroke in young adults. Neurology, 2003, 60(1):400-404.
15. Silverman IE, Restrepo L, Mathews GC. Poststroke seizures. Arch Neurol, 2002, 59(11):195-201.
16. Grewal J,Grewal HK,Forman AD. Seizures and epilepsy in cancer. Etiologies,evaluation and management.Curr Oncol Rep,2008,10(7):63-71.
17. 沈鼎烈, 王學峰. 臨床癲癇學. 上海:科學技術出版社, 2007:360.
18. Amatniek JC.Hausor WA,DelCastillo-Castaneda C,et al. Incidence and predictors of soizures in patients with Alzheimer's disease.Epilepsia,2006, 47(7):867-872.
19. Mendez MF, Lim GTH. Seizures in elderly patients with dementia:epidemiology and management. Drugs Aging, 2003, 20(11):791-803.
20. de la Courtte A,Breteler MM,Meinardi H, et al. Prevalence of epilepsy in the eldedy:the Rotterdam study.Epilepsia,1996,37(1):141-147.
21. Craig I,Tallis R.General practice nmnagement of adult-onset epilepsy analysed.Care Elderly,1991,3(2):69-72.
22. Watson P, Conroy A, Moran G, et al. Retrospective study of sensitivity and specificity of EEG in the elderly compared with younger age groups. Epilepsy Behav, 2012, 25(6):408-411.
23. Werhahn KJ, Trinka E, Dobesberger J, et al. A randomized, double-blind comparison of antiepileptic drug treatment in the elderly with new-onset focal epilepsy. Epilepsia, 2015, 56(3):450-459.
24. Papazian O, Canizales E, Alfonso I, et al. Reversible dementia and apparent brain atrophy during valproate therapy. Ann Neurol, 1995,38(6):687-691.
25. Leppik IE. Treatment of epilepsy in the elderly. Curr Treat Options in Neurol, 2008,10(8):239-215.

Journal of Epilepsy

The clinical analysis of senile epilepsy

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