[Epilepsy in the third age: seizures presenting after the age of 60 years (author's transl)]

In a group of 400 epileptic inpatients of the Neurological Clinic of Parma, 82 were over 60 years of age. Only 59 of them presented fits for the first time after the 60th year of age and in 78% of these, a definite anatomical damage could be demonstrated (neuroradiological investigations). One half of the epileptic syndromes with known etiology were thought to be related to cerebrovascular disease, but only few cases followed a stroke with persistent neurological symptoms. Intracranial space-occupying lesions were found to be the cause of epilepsy in 17% of cases. Partial epileptic seizures, secondarily generalized seizures, clinical signs of neurological damage, slow focal changes in the E.E.G. were the main features of this group of patients. In 22% of cases, miscellaneous causes were found: head injuries, exogenous intoxications due to accidental or iatrogenic ingestion, or alcoholic abuse. Relatively frequent were the seizures appearing in the course of degenerative or slow viruses induced encephalopathies. In 22% no demonstrable cause was found. Adequate follow-up may help us to discover etiological factors which at present are not obvious, but some form of idiopathic epilepsy with onset in this age range cannot be definitively ruled out. Only in 15% of cases interictal E.E.G. changes consisted in specific generalized or focal paroxysmal discharges (spikes, polyspikes, polyspike-and-wave). In about half of the cases the interictal E.E.G. failed to provide valuable informations, but an ictal E.E.G. could be obtained in 13 cases out of 59.