Seizures in the elderly: Etiology and prognosis

Alana Holt-Seitz, Elaine C. Wirrell, Mecheri B. Sundaram

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Purpose: To determine the etiology, early mortality, predictors of prognosis and diagnostic yields of EEG and CT scans of the head in new-onset seizures in elderly patients. Methods: EEG records for the north-central region of Saskatchewan, between 01./94 and 12/95 were reviewed to identify all adults aged 60 years or older with new-onset seizures. Information on demographics, seizure type, etiology, EEG and neuroimaging studies, anti- epileptic treatment and course of epilepsy was obtained by review of medical records and interview with the patient and/or family member. Results: Of 88 eligible subjects, 61 (69%) were contacted for follow-up, 19 (22%) were deceased (12 of whom who had a serious underlying etiology to their seizures, which was obvious at the time of initial presentation and led shortly to their demise), 4 (5%) were lost to follow-up and 4 (5%) refused participation. Excluding those refusing participation, 74/84 (88%) patients presented with partial or secondarily generalized seizures. Seizures were cryptogenic in 38/84 (45%), and due to stroke in 19/84 (23%). EEGs were abnormal in 61/84 (73%) cases, with epileptiform discharge in 33/84 (39%). CT scans were abnormal in 57/84 (68%) cases with acute pathology in 29/84 (35%). Of the 61 patients participating in the follow-up interview, 54 (89%) were treated with antiepileptic medication and seizure control was usually successful. Predictors for ongoing seizures were more than 3 seizures at presentation, epileptiform activity on initial EEG and discontinuation of anti-epileptic medication for lack of efficacy. Conclusion: Prognosis of new- onset seizures in elderly patients is favorable if seizures are not symptomatic of a life-threatening disorder.

Original languageEnglish (US)
Pages (from-to)110-114
Number of pages5
JournalCanadian Journal of Neurological Sciences
Volume26
Issue number2
StatePublished - Jun 1 1999

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ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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