New onset seizures in Octogenarians

Area of Science:

• Neurology
• Geriatrics
• Epilepsy Research

Background:

• New-onset seizures occur 2-3 times more frequently in older adults compared to younger populations.
• Previous research has focused on seizure characteristics in individuals over 60 or 65 years.
• This study addresses the ILAE task force's 2023 call for data on epilepsy in the elderly.

Purpose of the Study:

• To assess the clinical characteristics of seizures in individuals aged 85 years and older.
• To identify risk factors associated with seizure recurrence in this specific age group.
• To contribute to the understanding and management of late-onset epilepsy.

Main Methods:

• Prospective data collection from electronic medical records.
• Comparison of clinical characteristics between seizure-free and seizure-recurrence groups.
• Analysis of seizure types, neuroimaging, EEG findings, and etiologies.

Main Results:

• 40 patients (mean age 88.7 years) were studied over 30 years.
• Generalized tonic-clonic seizures were most common (45%).
• Stroke was the most frequent identified etiology (27.5%), with 50% of cases having unidentified etiology.
• 47.5% of patients experienced seizure recurrence, with prior stroke history and use of phenytoin or clobazam being significant risk factors.

Conclusions:

• This study provides valuable characterization of late-onset seizures in the very elderly (over 85).
• Identified risk factors for recurrence include prior stroke and specific antiepileptic drugs.
• Timely and appropriate management is crucial for improving outcomes in this population.