Late-Onset Seizures and Epilepsy: Clinical Profiles, MRI Findings, EEG Patterns and ASM Response in A South Indian Elderly Cohort
Abstract number :
2.245
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2025
Submission ID :
340
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Thanisha Santhosh, MBBS – Manipal Hospital, HAL, Bangalore
Pramod Krishnan, MBBS, MD, DM – Manipal Hospital, HAL, Bangalore
Prakriti Ramamurthy, MBBS, MD – Manipal Hospital, HAL, Bangalore
Advaith N Rao, MBBS – Manipal Hospital, HAL, Bangalore
Donti Ramakrishna Anusha, MBBS, MD, DM – Manipal Hospital, HAL, Bangalore
Hemanth Arumugam, MBBS – Manipal Hospital, HAL, Bangalore
Talika Sibal, MBBS – Manipal Hospital, HAL, Bangalore
Rahul Ravindra, MBBS, MD – Manipal Hospital, HAL, Bangalore
Rationale:
With a surging global elderly population, new-onset seizures after age 60 which are classified as
late-onset seizures (LOS) or late-onset epilepsy (LOE) are increasingly encountered. LOS
includes provoked or cryptogenic single seizures, while LOE involves ≥2 unprovoked
seizures or one with high recurrence risk. As stroke and brain neoplasm rates rise with age, most
elderly seizures are lesional. However, patients with known lesions remain vulnerable to
non-lesional triggers like metabolic/electrolyte imbalances, hypoglycemia, autoimmune
encephalitis, or infections. Diagnosis and treatment are challenging due to comorbidities,
seizure mimics, lack of eyewitness accounts, and polypharmacy. This study aimed to
characterize seizure types, etiologies, imaging findings (including Fazekas grade), EEG
patterns, comorbidities, and treatment trends in elderly patients with LOS and LOE.
Methods: We conducted a prospective observational study (March 2020–November 2021) at a tertiary
center in South India. Patients aged ≥60 years with new-onset seizures were stratified into
LOS (acute symptomatic or cryptogenic) and LOE (unprovoked recurrent). All patients underwent
clinical assessments, brain MRI with Fazekas grading, EEG, and ASM review. Statistical
analysis included chi-square and t-tests with p value < 0.05 taken as significant.
Clinical Epilepsy