title: Clinical characteristics and treatment responses in new-onset epilepsy in the elderly.
abstract: OBJECTIVE
  Epidemiologic studies have shown that the incidence of epilepsy is the highest in the elderly population. Because the elderly constitutes the most rapidly growing population, epilepsy in this group is an important health issue worldwide. To identify the characteristics of epilepsy in the elderly, we reviewed our experience at a tertiary referral center in Japan.
  
  
  METHODS
  We searched all electronic medical records of the past 6 years at the epilepsy clinic of the hospital affiliated to our University-affiliated hospital. We defined an elderly person as an individual aged 65 years and above. All patients underwent history and physical examinations, 3T magnetic resonance imaging and/or computer tomography, and electroencephalogram (EEG). The diagnosis of epilepsy, age of onset, etiology, and antiepileptic medication were recorded.
  
  
  RESULTS
  We identified 70 patients who developed epilepsy after the age of 65 years. The mean age of seizure onset was 73.1 years and 52.9% patients were males. Complex partial seizures (CPS) without secondarily generalization (n=33, 47.1%) were most frequent. The most frequent diagnosis was temporal lobe epilepsy (n=50, 71.4%). Etiological diagnosis was possible in nearly 50% patients, including those with cerebrovascular disease. A clear cause of epilepsy was not found (i.e., non-lesional epilepsy) in 52.8% patients. Interictal EEG revealed focal epileptiform discharges in 72.9% (n=51) patients. Of the 54 patients who were followed more than 1 year, 42 patients (77.8%) were on antiepileptic monotherapy and 52 patients (96.3%) had been seizure-free for more than 1 year.
  
  
  CONCLUSIONS
  The most frequent diagnosis in our cohort of elderly persons with new-onset epilepsy was temporal lobe epilepsy. Non-lesional temporal lobe epilepsy was not uncommon. Epileptogenecity was relatively low in elderly patients and they responded well to antiepileptic medication.
authors.affiliation: Department of Neurology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan; Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: tnk-a@koto.kpu-m.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanaka
authors.forename: Naoki
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Taisaku
authors.initials: T
authors.lastname: Shouzaki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Toyota
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Yamano
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Tsuji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000505:Alopecia / Q000150:complications; D000927:Anticonvulsants / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000150:complications; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007564:Japan / Q000453:epidemiology; D056784:Leukoencephalopathies / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D013122:Spinal Diseases / Q000150:complications; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D000927:Anticonvulsants
keywords: Complex partial seizure; Elderly; Epilepsy; Non-lesional epilepsy; Temporal lobe epilepsy