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 29 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-nine men aged 60 to 84 years (mean 73) of age had a mean time to correct diagnosis of seizures of 2.1 years (median 1 year). Only nine of these were diagnosed immediately. Eight patientes had GTC seizures and all but one were immediately diagnosed. Fifteen patients had CPS and all but two had an immediate correct diagnosis. This was dependent on delays by the patient and the health care providers. If a history of cerebral vascular disease or arrhythmia was known the correct diagnosis was significantly delayed, except in one patient who was hospitalized during one episode and another patient with a prior history of GTC seizures. More severe concomitant medical disorders caused greater delays in the time to diagnosis. Eight patients were incorrectly diagnosed originally as TIAs. Limbic simple partial seizures occurred in six patients, and were initially ignored by all patients. Simple motor seizures occurred in five patients and were immediately and correctly diagnosed in two patients. The remaining five patients ignored their seizures for more than three 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 an attempt to attribute all of a patient[ssquote]s symptoms to a single diagnosis.
Support: This is a Veterans Administration (VA) Cooperative Study funded by the VA.