Abstracts

Rationale: Incidence of status epilepticus (SE) increases significantly after age 60. With an aging population and considering that the elderly have the highest SE-associated mortality of any age group, SE is becoming a more common problem confronting clinicians. Although SE is the first seizure in more than a quarter of new-onset elderly epilepsy, a comparison of the presentation of SE between geriatric onset epilepsy (GOE; age of onset 55 years or older) and non-GOE (age of onset less than 55 years) in elderly population has not been made yet.Methods: Following IRB approval, a retrospective study was performed identifying a list of all patients age 65 years or older at our institution between January 2012-July 2014 with the probable diagnosis of seizure and epilepsy using ICD-codes 345/780. 431 patients were recognized and screened for eligibility. Patients with unconfirmed diagnosis of epilepsy, psychogenic non-epileptic seizures, syncope, vertigo, transient ischemic attack, who were not on antiepileptic drugs and who had a follow-up period less than 30 days were excluded. Age of onset of seizures was identified, and 236 eligible patients were stratified into GOE and non-GOE groups. Demographic and clinical data including the presence of history, type (convulsive vs. non-convulsive) and the trigger factors of SE, were collected in each individual.Results: 15% of patients in GOE group had a history of SE that was higher than non-GOE group (2%) (p value < 0.05). The two groups did not differ with regard to type of SE (convulsive vs. non-convulsive) (p value > 0.05). Intracerebral hemorrhage (36%) and ischemic stroke (36%) were the most frequent triggers of SE in GOE group with these factors being less common in non-GOE group.Conclusions: SE is more common in GOE, however we did not find non-convulsive SE to occur more frequently. The underlying etiology did differentiate the GOE group from the non-GOE group with intracerebral hemorrhage and ischemic stroke more frequent in GOE group. The presence of certain triggers increases the likelihood of SE in GOE patients, emphasizing the need for higher suspicion of SE in this vulnerable group in order to prevent morbidity and mortality.