title: Risk factors of recurrent seizure, co-morbidities, and mortality in new onset seizure in elderly.
abstract: OBJECTIVE
  To determine the risk factors of seizure recurrence and the most common comorbidities in elderly patients with epilepsy.
  
  
  METHODS
  We did a retrospective study of 278 patients older than 65 years with first seizure. We evaluated electrolytes, blood glucose, urea and creatinine levels, and performed electrocardiography (ECG), and routine electroencephalogram (EEG) on all patients. We evaluated seizure recurrence and comorbidities at 2 years.
  
  
  RESULTS
  Univariate analysis found that significant (P<0.05) factors affecting seizure recurrence were etiology of seizure, EEG, and status epilepticus at first presentation. In multivariate regression analysis, etiology of seizure and EEG were significant statistical factors in seizure recurrence at 2 years follow up. Age, sex, duration of time between first seizure and diagnosis of seizure, seizure type, misdiagnosis of non-epileptic seizure, and use of antiepileptic drugs were not significant factors for predicting seizure recurrence. Depression and anxiety were the most common comorbidities in our study, followed by sleep-related disorders and stroke. There were no statistically significantly differences in comorbidities between patients who remained seizure free and patients who had recurrent seizure.
  
  
  CONCLUSIONS
  Most of the new onset seizures in our elderly patients were focal onset. Acute symptomatic etiology, remote symptomatic etiology, progressive symptomatic etiology and abnormal EEG features were powerful predictors of seizure recurrence, and mood disorder, sleep disorder and stroke were the common comorbidities.
authors.affiliation: Neurology Unit, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. pkanitpo@medicine.psu.ac.th
authors.forename: Kanitpong
authors.initials: K
authors.lastname: Phabphal
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.forename: Kitti
authors.initials: K
authors.lastname: Limapichat
authors.forename: Pornchai
authors.initials: P
authors.lastname: Sathirapanya
authors.forename: Suwanna
authors.initials: S
authors.lastname: Setthawatcharawanich
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D015897:Comorbidity; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D013226:Status Epilepticus; D013785:Thailand / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants
keywords: Co-morbidity; Elderly; Recurrent seizure; Thailand