Abstracts

Rationale: The aim of this study was to examine the frequency of interictal epileptiform activity and its relation to aetiology and type of seizure.Methods: This retrospective-prospective study refers to two-year long period, and it has been done at the Department of Neurology of the Clinical Center of Montenegro, Podgorica. A group of 57 patients, with seizures onset at age 65 or over, was examined. There were 37 (64.9%) male and 20 (35.1%) female patients. The mean age of all patients was 67.2 years. Neurological examination, EEG (at least 4 interictal recordings), CT, Doppler sonography and cardiological evaluation were performed. Results: The most common aetiology was stroke which was observed in 37% of patients. Alcohol abuse was present in 23% of cases, head injury in 14% and brain tumors as well as CNS infections in 10.5% of patients. The aetiology remained unknown in 3 patients. Generalized tonic-clonic seizure was the most frequent type of seizure (46%). Partial seizures with or without secondary generalization were seen in 40% of patients. The rest of the patients (14%) experienced other types of seizures and 2 of those patients had nonconvulsive status epilepticus. Pathological EEG was found in 29 (50.1%) patients. Generalized discharges were detected in 7.0% of cases. Focal epileptiform activity as well as focal nonspecific activity was found in 12.3% of patients. In 19.3% of patients, EEG showed diffuse nonspecific activity. In two patients with nonconvulsive status epilepticus (psychic changes in patients with previously diagnosed epilepsy), focal epileptiform activity in the EEG was crucial for treatment and cessation of status epilepticus. The EEG finding was normal in 49.1% of patients. Pathological EEGs were significantly more frequent in patients with partial attacks, partial attacks with secondary generalization, atypical and myoclonic attacks in coma than in patients with generalized tonic-clonic seizures(p=0.10). Conclusions: EEG was abnormal in half of patients. The frequency of interictal epileptiform activity was quite low in comparison to nonspecific EEG changes. Analysis of EEG recordings failed to show the focal temporal slowing, possibly due to age of patients. The most frequent cause of epilepsy in examined patients was stroke and the most common seizure type was generalized tonic-clonic seizure. The importance of EEG in elderly patients is especially significant in cases of nonconvulsive status epilepticus where it plays a key role in treatment decisions.