Comparison of Clinical Characteristics of Epilepsy in Two Age Groups of 20-60 and More than 60 Years Old among the Patients Referred to Isfahan City, Iran, Epilepsy Clinics during 2014-2015

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Neurology, School of Medicine AND Neurology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: We aimed to compare different clinical characteristics of epilepsy among two age groups of 20-60 and more than 60 years old.Methods: This retrospective, cross-sectional study was conducted during 2014-2015 in epilepsy clinics located in Isfahan city, Iran. The inclusion criteria were defined as definitive diagnosis of epilepsy, age of older than 20 years, and having medical record in Isfahan epilepsy clinics. Patients with incomplete medical records were excluded. Patients’ medical records were reviewed for seizure characteristics, demographic and paraclinical data; these findings were compared between the two age-groups. 200 patients were included in the study and 23 of them were excluded because of incomplete medical records.Findings: 120 cases (67.8%) were under 60 years old and 81 cases (45.8%) were men. The most frequent seizure type in younger and older age-group was generalized tonic-colonic (35.0%) and mixed seizures (29.8%), respectively. Abnormal brain magnetic resounance imaging (MRI) (66.7% versus 37% and P < 0.001), computed tomography (CT) scan (59.6% versus 30.9% and P < 0.001) and laboratory data (22.8% versus 8.5% and P = 0.009) were more frequent in older age-group. Family history of seizure was seen more in younger age-group (51.7% versus 29.8%, P = 0.006).Conclusion: We found that elderly patients presented more with complex partial and mixed seizures while the younger population presented more with generalized seizures. Abnormal findings in brain CT scan and MRI were seen more in older patients and younger patients were more likely to have family history of epilepsy.

Keywords

References

  1. Chang BS, Lowenstein DH. Epilepsy. N Engl J Med 2003; 349(13): 1257-66.
  2. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014; 55(4): 475-82.
  3. Fisher RS, van Emde BW, Blume W, Elger C, Genton P, Lee P, et al. Epileptic seizures and epilepsy: definitions proposed by the International League against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia 2005; 46(4): 470-2.
  4. Annegers JF, Hauser WA, Lee JR, Rocca WA. Incidence of acute symptomatic seizures in Rochester, Minnesota, 1935-1984. Epilepsia 1995; 36(4): 327-33.
  5. Togonu-Bickersteth F. Chronological definitions and expectations of old age among young adults in Nigeria. J Aging Stud 1987; 1(2): 113-24.
  6. Sander JW, Hart YM, Johnson AL, Shorvon SD. National General Practice Study of Epilepsy: newly diagnosed epileptic seizures in a general population. Lancet 1990; 336(8726): 1267-71.
  7. Annegers JF, Hauser WA, Lee JR, Rocca WA. Secular trends and birth cohort effects in unprovoked seizures: Rochester, Minnesota 1935-1984. Epilepsia 1995; 36(6): 575-9.
  8. Wallace H, Shorvon S, Tallis R. Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy. Lancet 1998; 352(9145): 1970-3.
  9. de la Court, Breteler MM, Meinardi H, Hauser WA, Hofman A. Prevalence of epilepsy in the elderly: the Rotterdam Study. Epilepsia 1996; 37(2): 141-7.
  10. Cloyd J, Hauser W, Towne A, Ramsay R, Mattson R, Gilliam F, et al. Epidemiological and medical aspects of epilepsy in the elderly. Epilepsy Res 2006; 68(Suppl 1): S39-S48.
  11. Ramsay RE, Rowan AJ, Pryor FM. Special considerations in treating the elderly patient with epilepsy. Neurology 2004; 62(5 Suppl 2): S24-S29.
  12. Hauser WA. Seizure disorders: the changes with age. Epilepsia 1992; 33(Suppl 4): S6-14.
  13. Brodie MJ, Elder AT, Kwan P. Epilepsy in later life. Lancet Neurol 2009; 8(11): 1019-30.
  14. Noroozian M. The elderly population in Iran: an ever growing concern in the health system. Iran J Psychiatry Behav Sci 2012; 6(2): 1-6.
  15. Glauser T, Ben-Menachem E, Bourgeois B, Cnaan A, Chadwick D, Guerreiro C, et al. ILAE treatment guidelines: evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia 2006; 47(7): 1094-120.
  16. Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen HW, Mathern G, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010; 51(6): 1069-77.
  17. Leppik IE, Walczak TS, Birnbaum AK. Challenges of epilepsy in elderly people. Lancet 2012; 380(9848): 1128-30.
  18. Acharya JN, Acharya VJ. Epilepsy in the elderly: Special considerations and challenges. Ann Indian Acad Neurol 2014; 17(Suppl 1): S18-S26.
  19. Hussain SA, Haut SR, Lipton RB, Derby C, Markowitz SY, Shinnar S. Incidence of epilepsy in a racially diverse, community-dwelling, elderly cohort: results from the Einstein aging study. Epilepsy Res 2006; 71(2-3): 195-205.
  20. Martin RC, Faught E, Richman J, Funkhouser E, Kim Y, Clements K, et al. Psychiatric and neurologic risk factors for incident cases of new-onset epilepsy in older adults: data from U.S. Medicare beneficiaries. Epilepsia 2014; 55(7): 1120-7.
  21. Stephen LJ, Brodie MJ. Epilepsy in elderly people. Lancet 2000; 355(9213): 1441-6.
  22. Morillo LE. Temporal lobe epilepsy in the elderly. Epilepsy Res Treat 2012; 2012: 641323.
  23. Bergey GK. Initial treatment of epilepsy: special issues in treating the elderly. Neurology 2004; 63(10 Suppl 4): S40-S48.
Journal of Isfahan Medical School
Volume 34, Issue 411 - Serial Number 411
November and December 2017
Pages 1523-1530

Files

History

  • Receive Date: 16 October 2016
  • Revise Date:
  • Accept Date: 06 April 2022

Share

How to cite

Statistics