Abstracts

RATIONALE: The onset of epilepsy often occurs in the elderly population. From our observations the time to correct diagnosis is often delayed. Our interest is to investigate this phenomenon. METHODS: We reviewed the charts of 22 patients enrolled in the Veterans Administration Cooperative Study of new onset epilepsy in the elderly. No patients were profoundly demented or had known fatal illnesses. Concomitant medical diseases were permitted. RESULTS: Twenty-two men aged 60 to 84 years (mean 73)of age had a mean time to correct diagnosis of seizures of 1.8 years (median 1 year). Only seven of these were diagnosed immediately. Five patients had GTC seizures and were immediatly diagnosed. Ten patients had CPS and all but one had an immediate correct diagnosis. This was dependent on delays by the patient and the health care providers. If a prior history of cerebral vascular disease or arrhythmia was known the correct diagnosis was significiantly delayed. More severe concomitant medical disorders caused greater delays in the time to diagnosis. Four patients were incorrectly diagnosed initially as TIAs. Limbic simple partial seizures occurred in 4 patients and were initially ignored by all patients. Simple motor seizures occurred in 4 patients and were immedicately and correctly diagnosed in 1 patient. The remaining 3 patients ignored their seizures for more than 3 months prior to seeking medical attention. CONCLUSIONS: We observed significant delays in the correct diagnosis of seizures in this population. Two reasons we feel contribute to this problem are the lack of awareness of partial seizures by the public and health care providers and the concept of tyring to attribute all of a patients symptoms to a single diagnosis.