PMID- 23369763
OWN - NLM
STAT- MEDLINE
DCOM- 20130912
LR  - 20191210
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 27
IP  - 1
DP  - 2013 Apr
TI  - Outcome of newly-diagnosed epilepsy in older patients.
PG  - 29-35
LID - S1525-5050(12)00735-4 [pii]
LID - 10.1016/j.yebeh.2012.11.041 [doi]
AB  - INTRODUCTION: The annual incidence of seizure disorders rises sharply after the 
      age of 60. Treatment is complicated by the normal physiological changes of aging, 
      comorbid diseases, and polypharmacy. Despite this, approximately 80% of the 
      patients become seizure-free. OBJECTIVES: The objectives of this study were to 
      (1) analyze the outcome of a cohort of patients with newly-diagnosed epilepsy 
      over the age of 65, (2) describe epilepsy etiology and seizure type, and (3) 
      classify the outcome according to the latest ILAE classification proposal for 
      drug-resistant epilepsy (2010). METHODS: All patients with newly-diagnosed 
      epilepsy over the age of 65 who were evaluated in two different institutions were 
      included. Seizures and epilepsy syndromes were classified according to the 
      International League Against Epilepsy proposal (2010). Epilepsy outcomes were 
      also analyzed according to the proposal of the ILAE Commission on Therapeutic 
      Strategies (2010). RESULTS: One hundred and twenty-two patients were included 
      with a median follow-up time of 15 months. Median age of diagnosis was 78 years. 
      Seventy-seven patients (55%) had epilepsy of unknown cause, and 55 (45%) had 
      structural-metabolic epilepsy. The proportions of seizure-free patients at 6, 12, 
      18, and 24 months were 90%, 77%, 74%, and 67%, respectively. Thirty percent of 
      patients experienced adverse effects (AEs). We found a statistically significant 
      trend toward a higher frequency of AEs as the number of concomitant medications 
      rose and in younger patients. According to the 2010 ILAE classification proposal 
      for drug-resistant epilepsy criteria, 55.8% of the patients were seizure-free, 
      12.3% had treatment failure, and 32% had undetermined seizure outcome. 
      CONCLUSION: Patients with newly-diagnosed epilepsy after the age of 65 have very 
      good chances of achieving seizure control with AED treatment. It seems that 
      fulfilling the ILAE classification proposal for drug-resistant epilepsy (2010) 
      criteria for seizure freedom was more difficult in our cohort. Older patients 
      also seem to be more prone to suffering from AEs.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Besocke, A G
AU  - Besocke AG
AD  - Neurology Department, Hospital Italiano de Buenos Aires, Argentina. 
      agbesocke@gmail.com
FAU - Rosso, B
AU  - Rosso B
FAU - Cristiano, E
AU  - Cristiano E
FAU - Valiensi, S M
AU  - Valiensi SM
FAU - Garcia, M del C
AU  - Garcia Mdel C
FAU - Gonorazky, S E
AU  - Gonorazky SE
FAU - Romano, L M
AU  - Romano LM
LA  - eng
PT  - Journal Article
DEP - 20130129
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aging/*pathology
MH  - Cohort Studies
MH  - Epilepsy/classification/*diagnosis
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - *Outcome Assessment, Health Care
MH  - Retrospective Studies
MH  - Statistics, Nonparametric
MH  - Time Factors
EDAT- 2013/02/02 06:00
MHDA- 2013/09/13 06:00
CRDT- 2013/02/02 06:00
PHST- 2012/07/25 00:00 [received]
PHST- 2012/11/14 00:00 [revised]
PHST- 2012/11/17 00:00 [accepted]
PHST- 2013/02/02 06:00 [entrez]
PHST- 2013/02/02 06:00 [pubmed]
PHST- 2013/09/13 06:00 [medline]
AID - S1525-5050(12)00735-4 [pii]
AID - 10.1016/j.yebeh.2012.11.041 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2013 Apr;27(1):29-35. doi: 10.1016/j.yebeh.2012.11.041. Epub 2013 
      Jan 29.