Clinical features and prognosis of epilepsy in the elderly in western China

To investigate the characteristics and prognosis of epilepsy amongst older people hospitalized in southwestern China with newly diagnosed epilepsy.

We prospectively enrolled people older than 65 years who were admitted to a tertiary epilepsy center in West China between January 2008 and January 2013. Participants were divided into early-onset group (those who had a first seizure before age of 65) and late-onset group (those in whom the first seizure occurred after age of 65). Clinical data were collected and all participants were followed for two years.

Of 340 people enrolled, focal seizure (84%) was the most frequent seizure type. Status epilepticus (64.4% vs. 46.7%, p=0.022) and structural epilepsy (59.3% vs. 40.0%, p=0.015) were more prevalent in late-onset group than early-onset group. Ischemic stroke was the leading putative cause (22.6%) in elderly epilepsies. Around 80% were given anti-epileptic drugs (AEDs) for treatment. Forty-two people did not complete the study, of whom 26 were lost to follow-up and 16 died for causes other than epilepsy. Of the 298 who completed the follow-up, 240 (80.5%) achieved significant seizure reduction. Logistic regression analysis indicated that late-onset epilepsies and AEDs treatment were associated with more favorable seizure outcome at two-year follow-up (OR=4.029 and 92.007, respectively). The number of AEDs intake exerted no significant impact on seizure outcome.

In older people, late-onset epilepsies differed in several aspects from early-onset epilepsies. The overall effectiveness of AEDs treatment in older people was satisfactory.