Abstracts

RATIONALE: After reviewing this data the participants should be able to identify various types of delays in the diagnosis of epilepsy in the elderly population.
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 128 patients enrolled in the Veterans Administration Cooperation Study of new-onset epilepsy in the elderly. No patients were profoundly demented or had known fatal illnesses. Concomitant medical diseases were permitted.
RESULTS: One hundred twenty-seven men and one woman aged 60 to 96 years (mean 75) of age had a mean time to corrert diagnosis of seizures of 2.3 years (median 1 year). Forty-seven individuals were diagnosed immediately. Forty-eight patients had GTCs and two-thirds were immediately diagnosed. Sixty-three patients had CPSs, one quarter had an immediate diagnoses. 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. More severe concomitant medical disorders caused greater delays in the time to diagnosis. Thirty-five percent of patients with SPSs were incorrectly diagnosed originally as having TIAs. Limbic simple partial seizures occurred in six patients, and were initially ignored by all patients. Patients with SPSs tended to be self-referred, while those with CPSs or GTCs were mostly referred by family members or health care providers.
CONCLUSIONS: We observed significant delays in the correct diagnosis of seizures in the elderly 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 patients symptoms to a single diagnosis.
[Supported by: This is a Veterans Administration (VA) Cooperative Study funded by the VA.]