The Use of VEEG for Evaluation of Spells in the Elderly.
Abstract number :
1.087
Submission category :
Year :
2001
Submission ID :
2853
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
I. Danielsson, MD, PhD, Neurology, University of Maryland, Baltimore, MD; E. Barry, MD, Neurology, University of Maryland, Baltimore, MD; C. Port, PhD, Neuropsychology, University of Maryland, Baltimore, MD; A. Krumholz, MD, Neurology, University of Maryl
RATIONALE: Spells are common in the elderly population. Prolonged inpatient video EEG monitoring for diagnosis and treatment of such spells is an underused diagnostic tool.
METHODS: Over a 12 year period 74 patients 60 years and older were admitted for prolonged inpatient video EEG monitoring. The mean age was 69 years with a range from 60 to 84. 43 were females. For comparison purposes these patients were matched with 74 non-geriatric cases, consisting of the next consecutive admissions between the ages of 18 and 60 years. The mean age was 34 with a range from 18 to 59. 31 were males. We compared the two groups with regards to epileptic versus non epileptic events. The latter were sub classified as physiologic or psychiatric.
RESULTS: 3 of the 74 patients in the elderly population had both epileptic and non-epileptic events. 41 patients in the elderly group were diagnosed with non-epileptic events; 21 had psychiatric/behavior events and 20 had physiologic events. All of the 25 patients under 60 with non epileptic events had psychiatric/behavior events. Of the 30 elderly patients with epileptic events; there were 21 with partial seizures, 5 generalized, 3 in status epilepticus and 1 patient with a diffusely slow EEG. Of the 49 epileptic patients in the younger age group; 37 gad partial seizures, 9 generalized and 3 a diffusely slow EEG.
CONCLUSIONS: Inpatient monitoring is a useful tool for the diagnosis and differentiation of epileptic versus non epileptic events in the elderly population. Although more patients in the elderly age group have physiologic events a significant number still have psychiatric/behavior events. Generalized seizures are approximately equal between the two groups, (17 versus 18 %). The number of elderly patients with partial seizure are approximately half of that of the younger population, (33 versus 75 %). This difference could represent a selection bias, most younger patients are admitted for monitoring preceding seizure surgery