PMID- 36682749
OWN - NLM
STAT- MEDLINE
DCOM- 20230124
LR  - 20230201
IS  - 0301-2603 (Print)
IS  - 0301-2603 (Linking)
VI  - 51
IP  - 1
DP  - 2023 Jan
TI  - [Elderly Onset Epilepsy and Post-Stroke Epilepsy].
PG  - 59-67
LID - 10.11477/mf.1436204715 [doi]
AB  - It has been reported that the incidence of epilepsy in individuals over the age 
      of 75 years is similar to or higher than one year, suggesting that epilepsy is an 
      important clinical condition in older people. The aging rate in Japan, which 
      reached 27.3% in 2017, makes this an issue of increasing concern. Diagnosis 
      begins with the collection of medical history and knowledge of seizure semiology. 
      In the elderly, most seizures are of extratemporal origin with various seizure 
      semiologies. Difficulties in diagnosis lie in the influence of the autonomic 
      nervous system and nonconvulsive status epilepticus(NCSE). It is necessary to 
      suspect "epilepsy" for any sudden-onset episodes of atypical symptoms and unusual 
      behaviors. NCSE can be diagnosed by recording EEG for more than 6 hours. The 
      narrow therapeutic window and pharmacokinetics complicated by aging make 
      treatment much more difficult with anti-seizure medication(ASM). Comorbidities 
      and drug interactions should also be considered. Stroke is the most common 
      etiology of geriatric epilepsy. Despite several clinical reports on the risk 
      factors of post-stroke epilepsy(PSE)on the preventive administration of 
      enzyme-inducing ASM, a treatment protocol has not yet been established. 
      Prophylactic administration is not recommended; however, ASM is often 
      administered in the acute phase. Therefore, some guidelines for 
      non-enzyme-inducing ASM are required for efficient control of PSE.
FAU - Kunieda, Takeharu
AU  - Kunieda T
AD  - Department of Neurosurgery, Ehime University Graduate School of Medicine.
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - No Shinkei Geka
JT  - No shinkei geka. Neurological surgery
JID - 0377015
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Epilepsy/etiology/diagnosis
MH  - *Stroke/complications/drug therapy
MH  - *Status Epilepticus/diagnosis
MH  - Japan
MH  - Electroencephalography/adverse effects
MH  - Anticonvulsants/therapeutic use
EDAT- 2023/01/23 06:00
MHDA- 2023/01/25 06:00
CRDT- 2023/01/22 20:42
PHST- 2023/01/22 20:42 [entrez]
PHST- 2023/01/23 06:00 [pubmed]
PHST- 2023/01/25 06:00 [medline]
AID - 1436204715 [pii]
AID - 10.11477/mf.1436204715 [doi]
PST - ppublish
SO  - No Shinkei Geka. 2023 Jan;51(1):59-67. doi: 10.11477/mf.1436204715.