White Matter Lesions as a Risk Factor in New Onset Epilepsy in the Elderly
Abstract number :
2.118
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2021
Submission ID :
1825897
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
DAMIAN CONSALVO, MD, PhD - Ramos Mejia Hospital/Sanatorio de Los Arcos; Natali Bein, MD - Fellow, Neurology, Sanatorio de Los Arcos; Gala Lopez, MD - Resident, Neurology, Sanatorio de Los Arcos; Eliana Garino, MD - Staff, Neurology, Sanatorio de Los Arcos; Maria Teves Echazu, MD - Fellow, Neurology, Hospital Italiano Buenos Aires; Maria del Carmen Garcia, MD - Chief of Epilepsy, Neurology, Hospital Italiano Buenos Aires; Ramon Leiguarda, MD - Chief of Neurology, Neurology, Sanatorio de Los Arcos
Rationale: New-onset epilepsy is common in older age, and the etiology is unclear in 25-40% of the cases. The objective of this study was to evaluate the association between the white matter lesions (WML) and the risk of a first unprovoked seizure (FUS) and later developing epilepsy in patients older than 60 years.
Methods: Patients older than 60 years with a FUS were recruited and were compared with a control group without history of seizures. The participants were included from two epilepsy centers in Buenos Aires, Argentina. Exclusion criteria were patients with a pre-existing epileptogenic lesions and previous diagnosis of epilepsy. All patients underwent MRI to assess WML measured through the Manolio scale, we use a cut-off value ≥ 6 for a WML moderate/severe. Mean time of follow-up was 21 months.
Results: Were included 118 patients, 40 presented a FUS and 78 controls. No significant differences were found in potential vascular risk factors between both groups of patients. Regarding the WML, 67.9% of the forty patients with a FUS presented a Manolio scale on MRI ≥ 6, compared with 32.1% of the patients without seizures (p < 0.001). Of the 40 patients who presented a FUS, 24 (60%) met the diagnostic criteria for epilepsy for having a second unprovoked seizure during the follow-up or for presenting an abnormal EEG with epileptiform discharges. Mean time to development of epilepsy after a FUS was 12 months (range: 1 to 40). Those patients who develop epilepsy had more periventricular and subcortical WML than patients with only a FUS (p < 0.001).
Clinical Epilepsy