Video-EEG monitoring in a geriatric veteran population

Video-EEG monitoring is a standard tool to evaluate possible seizures. However, there are limited data available for the elderly population, and no data are available for the elderly veteran population. The records of 71 veterans ages 60 and older who underwent video-EEG monitoring at the Michael E. DeBakey Veterans Affairs Medical Center from 1999 to 2006 were reviewed. The average age was 68 years, and 94% were male. Typical events occurred in 34 of 71 patients (48%). Twelve patients (35%) had epileptic seizures; most were temporal lobe seizures (75%). The remaining 22 patients (65%) had a nonepileptic event. Of these, 10 (45%) had psychogenic nonepileptic seizures and 12 (55%) had other physiologic nonepileptic events. AEDs were previously prescribed in 14 of the 22 nonepileptic patients (64%). In our study, most events were nonepileptic, partly reflecting the unique nature of the VA population. There was a slightly higher number of physiologic nonepileptic events; however, psychogenic seizures are also frequently seen. Most of the patients with nonepileptic events were previously treated with AEDs. Most of the epileptic events captured were temporal lobe seizures. Video-EEG monitoring in the elderly is useful in the characterization of paroxysmal events.