Epilepsy in an elderly population: Classification, etiology and drug resistance

Area of Science:

• Neurology
• Geriatrics
• Epileptology

Background:

• Epilepsy affects diverse age groups, with unique characteristics in the elderly.
• Understanding epilepsy in older adults is crucial for tailored management.

Purpose of the Study:

• To characterize epilepsy in elderly individuals.
• To determine the prevalence of drug-resistant epilepsy (DRE) in this demographic using International League Against Epilepsy (ILAE) criteria.

Main Methods:

• A case-control study design was employed.
• 72 elderly patients (≥60 years) and 223 younger patients were retrospectively analyzed.
• Logistic regression identified factors associated with epilepsy in the elderly.

Main Results:

• Focal epilepsy was common (65%) in elderly patients; unknown etiology was most frequent (48%).
• Elderly patients had significantly lower rates of DRE (26%) compared to younger patients (51%).
• Stroke and psychiatric comorbidity were associated with epilepsy in the elderly, who were more often on monotherapy.

Conclusions:

• Elderly epilepsy patients present with distinct etiological profiles (e.g., stroke) and lower DRE prevalence.
• The findings highlight the need for specific clinical practice guidelines for epilepsy management in older adults.