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CT findings in late-onset epilepsy
V de la Sayette1, R Cosgrove, D Melanson
1Department of Neurology, Montreal Neurological Hospital, Quebec.
Summary
In patients over 50 experiencing new seizures, CT scans often show normal results or cerebral atrophy. Cerebral vascular disease is the most common cause of late-onset epilepsy, while tumors are rare.
Area of Science:
- Neurology
- Radiology
- Geriatrics
Background:
- Late-onset epilepsy (new-onset seizures after age 50) requires accurate etiological diagnosis.
- Computed Tomography (CT) is a common imaging modality for evaluating such patients.
Purpose of the Study:
- To analyze the CT findings in patients presenting with new-onset seizures after the age of 50.
- To determine the prevalence of various abnormalities and their association with seizure types.
Main Methods:
- Retrospective review of CT scans from 387 patients aged 50 and above with new-onset seizures.
- Categorization of seizure types (generalized, focal, indeterminate) and CT findings (cerebral atrophy, ischemic lesions, neoplasms, normal).
Main Results:
- A significant proportion (177/387) of patients had normal CT scans.
- Cerebral atrophy was the most common abnormality (113/387), followed by ischemic lesions (75/387).
- Cerebral neoplasms were uncommon (20/387), predominantly found in patients with focal seizures.
Conclusions:
- The majority of late-onset epilepsy cases present with normal CT scans or non-specific findings like cerebral atrophy.
- Cerebral vascular disease is a frequent underlying cause of late-onset epilepsy.
- Malignant brain tumors are an infrequent cause of new-onset seizures in this age group.