Abstracts

Recently there is remarkable increase in seizures in the elderly due to growing size of this segment of the population. In the literature there is little information about the characteristic presentation of epileptic and non-epileptic events in the elderly.
Therefore we report the results of Video EEG recordings in patients aged 60 or older who were admitted over 2 consecutive years to the epilepsy monitoring unit. We examined the records of all patients admitted to EMU between 12/1999 and 12/2001. All patients underwent continuous CCTV/EEG monitoring with cable telemetry using 64 channels Nicolet BMSI system, and scalp electrodes were placed according to international 10-20 system. Based on reasons for admission Video EEG reports were categorized into 1) diagnosis of events, 2) characterization and localization of seizures, 3) adjustment of medication, 4) status epilepticus (nonconvulsive). Fifty-eight patients were admitted to the EMU, 26 women between the age of 60-91 years and 32 men between the ages of 60-84 years. The main reasons for admission were diagnosis of events (57% of patients), followed by characterization and localization of events (36% of patients). There were 6 patients with PNES, 5 were women and 4 of them [gt]70 yrs old. All PNES patients presented with motor symptoms except for an 87 yrs old male who presented with abdominal spasm. Two of these 6 patients were suspected to have PNES before admission. Two patients were admitted with suspicion of SE, but none of them proved to have SE. The Most frequent diagnosis was NES (26 patients; 45%). Seven (27%) of these 26 patients were on AEDs, which were discontinued after the diagnosis. CPS was the most frequent seizure type, occurring in 22 patients and 6 of them (27%) had both CPS and secondary generalization. In the elderly, Video-EEG results in definite diagnosis in the majority of cases and leads to the discontinuation of unnecessary medication with its deleterious effects. PNES can occur in elderly, which needs to be recognized and managed properly.