Abstracts

Rationale: The aim of epilepsy treatment is to abolish seizures with minimal toxicity to the patient. Nevertheless, health singularities, lifestyle, age-related alterations in antiepileptic drugs (AED) response and drug interactions are special considerations needed to take into account. The main purpose of our study is to identify factors that may contribute to the abolishment /persistence of seizures or to drug toxicity in this particular group of patients. Methods: We evaluated all the epileptic patients aged more that 60 years old (yo) that attended our outpatient clinic since June 2006. Besides demographic data and characterization of seizures and epilepsy, several features were considered: duration of epilepsy, seizures type and frequency, treatment type and result, intake of other drugs and concomitant illness. Non parametric statistic methods were used. Results: Fifty seven patients were evaluated (26F:31 M) with a median age of 72 yo (min61 -max 88 yo). Most of them (60%) never had seizures before 60 yo. In 60% of the cases the etiology was unknown, 24% had cerebrovascular disease, the remaining 16% had dementia, trauma or cerebral neoplasms. 59% had partial seizures with or without secondarily generalization. Frequency was less than 1 per year in 61%. Although 50% had a recent epilepsy diagnosis, 40% of these patients were referred to our outpatient clinic, already on AED politherapy. When we tried to modify AED type or dosage, 20% did not accept the prescription. In those who remained seizure free, monotherapy was the only feature statistically significant. In our study, co morbidities, other medications, adverse events, alcohol intake and time of diagnosis did not show statistical influence on seizure control. Conclusions: Monotherapy shows to be the therapeutic strategy that guarantees greater probability to control seizures. Early politherapy and patient attitude (relatively to the attempt to modify AED treatment), show a lack of understanding about the disease. It becomes necessary to promote epilepsy knowledge among all the intervenients in the therapeutic procedure, in order to improve quality of life in elderly with epilepsy.