Abstracts

RATIONALE: Status epilepticus (SE) is a serious medical condition associated with significant morbidity and mortality. Few studies have addressed this condition in the elderly. The present paper examines characteristics of SE in this population.
At the end of this activity, participants should be able to discuss the characteristics of SE in the elderly patient.
METHODS: For this prospective study, data was obtained from the NIH Greater Richmond Metropolitan Area Status Epilepticus database. The elderly group (n=382) was defined as age 60 and greater. The adult group (n=318) was defined as 16 to 60 years of age.
RESULTS: A total of 382 cases, age 60 or greater, were available for analysis. Of these 54% were female and 61% non-white; 57% had no prior history of seizures and 71% had no prior history of SE. Generalized convulsive seizures accounted for 63%, partial convulsive 27%, and non-convulsive 10% of cases. Acute CNS events accounted for the largest etiology (42%), followed by remote symptomatic (24%), and hypoxic-anoxic (13%). The overall mortality rate was 38% with a 27% mortality for ages 60-69, 37% mortality for ages 70-79, and a 42% mortality for ages 80 and greater. Differences were seen when comparing the adult (16-60 years of age) and elderly populations (60 years and greater): more elderly cases (65%) presented with SE without prior seizure history than was seen in adults (44%); partial convulsive seizures were more common in the elderly (27%) than in the adult group (17%); and there was a significantly greater mortality in the elderly group, 23% versus 38% (Chi square = 19, df = 1, p [lt] 0.0001).
CONCLUSIONS: Elderly patients with SE represent a distinct population with unique characteristics. Most of the patients had no prior history of seizures or SE, and had a relatively high rate of nonconvulsive SE. Mortality was significantly higher in the elderly population than was seen in the non-elderly adult group.
[Supported by: NIH PO1 NS25630]