Abstracts

Rationale: The elderly population is increasing. Treatment of the elderly persons with epilepsy will be an important issue around the world. To reveal the characteristics of the epilepsies in the senior citizens, we reviewed our experience at the tertiary referral center in Japan. Methods: We searched all the electric medical record at the epilepsy clinic in our University affiliated hospital between May 1st and November 30th, 2007. Elderly person was defined older than 60 years. All the patients underwent history and physical, 3 tesla MRI and electroencephalography. Diagnosis of epilepsy, age of onset, etiology, antiepileptic medication dose, serum level and its responses were recorded. Results: We identified 76 patients with epilepsy who are older than 60 years. Of the 76 patients, 40 patients developed epilepsy after the age of 60 (group A), 36 patients had onset before the age of 60 (group B). In group A, 29 patients (72.5%) had temporal lobe epilepsy and 5 patients (12.5%) had frontal lobe epilepsy. Six patients (10%) were unclassified. Of the 36 patients who were seizure free, 31 patients on monotherapy and 5 patients (12.5%) were on two medications. Mean dose of the antiepileptic medication of the seizure free patients were; carbamazepine 176±95 mg, phenytoin 207±61 mg, valproate 600±400mg. Etiology of the epilepsy was clear in 12 patients (30%). In group B, the age of the onset of epilepsy ranged from 5 to 59, mean was 41 and median was 48 Twenty three patients (64%) were seizure fee on monotherapy or combination therapy. Conclusions: In our cohort of elderly persons with epilepsy, more than half of the patients had newly-onset epilepsy after the age of 60. Temporal lobe epilepsy was most frequently seen followed by frontal lobe epilepsy. Epileptogenecity in these patients is relatively lower because 90% of the patients were seizure free on modest dose of medication. Etiological diagnosis may not be easy in this group as compared to younger age group. Younger-age -onset patients who has intractable epilepsy continued to be dug-resistant, so that, it is also necessary to provide effective care for this group of patients.