Abstracts

The elderly in United States are representing a greater percentage of the general population than before. This age group has increased risk of developing epilepsy as compared to those who are younger. Previous reports indicate that in this age group the clinical presentation of new onset epilepsy is frequently varied and obvious epileptic seizures are sometimes not reported. Epileptiform activity in the EEG (EA) is highly specific for epilepsy when acute symptomatic conditions and PLEDS are excluded. We reviewed chief complaint (CC) and EEG findings in patients mimimum 65 years old with EA referred to the neurophysiology laboratory at Hahnemann University Hospital between October 2004 and April 2005 for possible new onset seizures. Patients with known additional acute CNS event, PLEDS, recent medication change, severe metabolic derangement or prior history of epilepsy were excluded. 20 patients were found to have EA. Mean age was 79.5 (range 69 to 92), 12 were women. Some patients had two CC. Most common CC was confusion (13), then came fall (4), witnessed seizure (3), syncope (2), focal weakness (1), aphasia (1) and hallucinations (1). Of risk factors there was dementia (5), stroke (4) and meningioma (1) while ten with no risk factors. EEG showed diffuse slowing (5), normal back ground (15), electrographic seizures (2). EA was localized in one temporal lobe (10), both temporal lobes (8), parietal (1), or frontal (1). Most common medical condition was arteral hypertension (10). Chief complaint in new onset epilepsy among the elderly is varied, confusion being the most common and witnessed seizures less common. Although stroke and dementia are risk factors, many have no risk factors. Electrographic seizures are seen occasionally, even without reported witnesses seizures.
We attempt to confirm these findings in a larger number of patients.