Bofei Tan , Qiang Liu , Mengyun Li , Jianming Wu , Feng Rao , Qing Zhang
{"title":"Clinical characteristics and treatment responses of epilepsy in the elderly in northwestern China","authors":"Bofei Tan , Qiang Liu , Mengyun Li , Jianming Wu , Feng Rao , Qing Zhang","doi":"10.1016/j.clineuro.2025.108887","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical characteristics and treatment responses of epilepsy in the elderly.</div></div><div><h3>Methods</h3><div>Consecutive epilepsy patients (age≥65) who were admitted to the tertiary medical center in northwestern China from 2019 to 2022 and were</div><div>divided into the early-onset epilepsy (EOE) group and the late-onset epilepsy (LOE) group. Clinical data were analyzed retrospectively, and all patients were followed for one year.</div></div><div><h3>Results</h3><div>A total of 239 elderly PWE (100 in the EOE group) were enrolled, with ischemic stroke being the primary cause (27.2 %). The proportion of epilepsy due to ischemic stroke was higher in the LOE group compared to the EOE group (33.8 % vs. 27.0 %, p = 0.007). Generalized tonic-clonic seizures (GTCS) were the most common seizure type in elderly PWE (34.7 %) and EOE group (46.0 %). Complex partial seizures (CPS) were the most common seizure type in the LOE group (30.2 %). Hypertension (49.8 %) was the most prevalent comorbidity, and it was more common in the LOE group than in the EOE group (56.8 % vs. 40.0 %, p < 0.05). Of the 207 patients who completed follow-up, 184 were on anti-seizure medications (ASMs) including125 being prescribed a single type of ASM and 59 two or more types. Among patients receiving one type of ASM, more EOE group received traditional ASM (55.6 % vs. 31.0 %), while more LOE group received novel ASM (69.0 % vs. 44.4 %, p = 0.006). More patients receiving two or more type of ASMs were included in the EOE group than in the LOE group (35.9 % vs. 22.6 %, p = 0.036). Seizure freedom was achieved in 61.8 % of the elderly PWE,and the seizure freedom rate was higher in the LOE group than in the EOE group(67.0 % vs51.7 %, p = 0.035).</div></div><div><h3>Conclusion</h3><div>In elderly PWE, there are differences between EOE and LOE across several aspects, including etiology, semiology, and ASMs selection, etc. Furthermore, patients with LOE having a higher likelihood of achieving seizure freedom. Conversely, more patients with EOE need two or more type of ASMs to control their seizures.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108887"},"PeriodicalIF":1.6000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neurology and Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0303846725001702","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To investigate the clinical characteristics and treatment responses of epilepsy in the elderly.
Methods
Consecutive epilepsy patients (age≥65) who were admitted to the tertiary medical center in northwestern China from 2019 to 2022 and were
divided into the early-onset epilepsy (EOE) group and the late-onset epilepsy (LOE) group. Clinical data were analyzed retrospectively, and all patients were followed for one year.
Results
A total of 239 elderly PWE (100 in the EOE group) were enrolled, with ischemic stroke being the primary cause (27.2 %). The proportion of epilepsy due to ischemic stroke was higher in the LOE group compared to the EOE group (33.8 % vs. 27.0 %, p = 0.007). Generalized tonic-clonic seizures (GTCS) were the most common seizure type in elderly PWE (34.7 %) and EOE group (46.0 %). Complex partial seizures (CPS) were the most common seizure type in the LOE group (30.2 %). Hypertension (49.8 %) was the most prevalent comorbidity, and it was more common in the LOE group than in the EOE group (56.8 % vs. 40.0 %, p < 0.05). Of the 207 patients who completed follow-up, 184 were on anti-seizure medications (ASMs) including125 being prescribed a single type of ASM and 59 two or more types. Among patients receiving one type of ASM, more EOE group received traditional ASM (55.6 % vs. 31.0 %), while more LOE group received novel ASM (69.0 % vs. 44.4 %, p = 0.006). More patients receiving two or more type of ASMs were included in the EOE group than in the LOE group (35.9 % vs. 22.6 %, p = 0.036). Seizure freedom was achieved in 61.8 % of the elderly PWE,and the seizure freedom rate was higher in the LOE group than in the EOE group(67.0 % vs51.7 %, p = 0.035).
Conclusion
In elderly PWE, there are differences between EOE and LOE across several aspects, including etiology, semiology, and ASMs selection, etc. Furthermore, patients with LOE having a higher likelihood of achieving seizure freedom. Conversely, more patients with EOE need two or more type of ASMs to control their seizures.
期刊介绍：
Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
