Demographic and Electroclinical Features of Elderly Onset Temporal Lobe Epilepsy
Abstract number :
1.135
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2018
Submission ID :
497160
Source :
www.aesnet.org
Presentation date :
12/1/2018 6:00:00 PM
Published date :
Nov 5, 2018, 18:00 PM
Authors :
Yasukiyo Araki, NHO Shizuoka Institute of Epilepsy and Neurological Disorders; Akihiko Kondo, NHO Shizuoka Institute of Epilepsy and Neurological Disorders; Hitoshi Ikeda, Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders; Nao
Rationale: The incidence of epilepsy in the elderly has been increased. It is generally stated that elderly patients have few auras or motor symptoms, however, there is little objective evidence to support or refute this, especially in patients with elderly “onset” temporal lobe epilepsy (TLE). The aim of our study is to investigate the demographic and electroclinical features of elderly onset TLE. Methods: We retrospectively included 41 patients (23 male and 18 female) who underwent video-EEG monitoring between January 2010 and December 2017; at least one epileptic seizure was recorded; their seizure onset was aged 60 years or older, and their epileptogenic focus was consistent with temporal lobe (Elderly group). Ictal electroclinical features of Elderly group were compared with those of 41 TLE patients with hippocampal sclerosis (HS) aged 18 to 44 years (17 male and 24 female) who underwent resective surgery with Engel class I outcome (HS group). Results: The age at seizure onset and at video-EEG examination was 66.0±5.1 and 68.2±5.4 years, respectively. Etiology of Elderly group consisted of amygdala enlargement (n=12, 29.3%), dementia (n=4, 9.8%), encephalitis (n=3, 7.3%) and unknown (n=20, 48.8%). Auras in Elderly group were less often than HS group (24.4% vs 75.6%, p<0.01). The prominent feature of focal impaired awareness seizures in Elderly group was not motor or automatism but behavior arrest (58.5% vs 22.0%, p<0.01). A history of focal to bilateral tonic-clonic seizure was less often in Elderly group (17.1% vs 45.0%, p<0.05). Ictal EEG discharge patterns were not different in both groups, but the duration of ictal discharge in Elderly group was shorter than HS group (30.2±16.7 vs 77.3±40.9 second, p<0.01). Conclusions: Our study demonstrated that amygdala enlargement was one of the common etiologies in Elderly group. Elderly group had less auras or motor symptoms shown by video EEG-monitoring. Furthermore, ictal discharge was shorter in Elderly group. Therefore, shorter seizures with milder phenotype without warning signs characterize the elderly onset TLE compared to TLE with HS. Funding: This study was granted by Eisai Co., Ltd.