Abstracts

Rationale: At the Epilepsy Clinic, Aalborg University Hospital, Denmark our clinical observations indicate a rising trend in the referral of older individuals for epilepsy evaluation. Continuous attention to precise patient selection is crucial, especially as elderly patients often present with more nonspecific symptoms, such as confusion or syncope, raising the suspicion of epileptic seizures. The goal of this study is to evaluate the correlation between age and epilepsy diagnoses, and to assess our resource utilization in the diagnostic process.


Methods: Patients referred for epilepsy evaluation in our clinic between April 1, 2022 and April 2024 will be included, with analyses conducted on those with a 1-year follow up available. Demographics, age distribution, the resulting diagnostic work-up including CT/MRI brain imaging and electroencephalogram (EEG), final diagnosis, ASM treatment, and number of re-admissions with seizures is registered.

Using Poisson regression, the relative risk (RR) of epilepsy is modelled as a function of age using a restricted cubic spline. This spline represents the risk by connecting several pieces, each assumed to follow a specific curve, herein three points is placed at 10%, 50% and 90% quantiles where the curves have been connected. Each segment of the curve is a third-degree polynomial.


Results: In a preliminary analysis of our data, a total of 158 patients with a one-year follow-up were included. All patients received a 1-hour clinical evaluation by a physician and additional diagnostic workup. Descriptive data regarding demographics, diagnostic workup and readmissions was analyzed. Ages ranged from 18 to 95 years (median age 52 years) and 59.7% were male. A Poisson regression curve indicated a rising trend in the risk of receiving an epilepsy diagnosis with advancing age, peaking around 55 years with a slight decrease thereafter. RR of patients > 55 years of age receiving an epilepsy diagnosis: RR = 1.18, 95% CI (0.69-2.01, P-value: 0.55) compared to patients < 55 years. The distribution of diagnosis codes after 1-year follow-up was in accordance with comparable studies (1), with 25.2% of patients receiving an epilepsy diagnosis, while 20.8% of patients had experienced a first-time epilepsy-like seizure. Within the first year 20 patients (12.6%) experienced one or more admissions due to a seizure.


Conclusions: Of the 158 patients included so far, 25.2% received an epilepsy diagnosis within a year. Poisson regression show a trend of increasing risk of receiving an epilepsy diagnosis with advancing age, peaking at 55 years, however this was not statistically significant. Most patients underwent brain imaging and EEG studies either before or within 3 months following the first visit. Further analysis of the sensitivity of EEG and brain imaging in relation to age will be performed, and our cohort will be increased to exceed 400 patients.


Funding: None.