[Epilepsy in later life: seizures persisting after the age of 60].

M G Terzano, D Mancia, O Zacchetti, G C Manzoni
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Abstract

In a group of 657 epileptic patients there were 51 presenting with fits even after having reached the age of 60. The onset of seizures dated back to the first 20 years in 15 patients between 20 and 40 years in 15 and between 40 and 60 years in 21. In 67% of the cases it was possible to determine the cause of seizures. The aetiology was unevenly distributed within each group. In the first group (up to 20 years) the P.G.E. forms prevail. In the second (up to 40 years) post traumatic epilepsy and inflammatory processes were predominant, while in the third (up to 60 years) vascular and tumoral pathology seem to be prevalent. 43% of the patients showed paroxysmal abnormalities in the EEG and these were still present even after to age of 60 years in more than fifty per cent. After the age of 60 we found no case of benign epilepsy amenable to complete recovery. Patients older than 60 present epilepsies of mild severity. In symptomatic epilepsies the lesional factors were not subject to evolution and the epileptogenic focuses were stable and persistent. In partial epilepsy there were more cases of complex symptomatology (86%) than cases of elementary symptomatology (14%) The evolution of seizures in old age is considered together with the importance of all factors influencing recurrency.

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[晚年癫痫:60岁以后持续发作]。
在657例癫痫患者中,有51例在60岁后仍出现癫痫发作。15例患者癫痫发作可追溯到20岁前15例为20 - 40岁21例为40 - 60岁。在67%的病例中,可以确定癫痫发作的原因。各组的病因分布不均匀。在第一组(20岁以下)中,P.G.E.表格占主导地位。在第二个(长达40年)创伤后癫痫和炎症过程是主要的,而在第三个(长达60年)血管和肿瘤病理似乎是普遍的。43%的患者在脑电图中表现出阵发性异常,这些异常甚至在60岁后仍然存在,超过50%。60岁后,我们发现没有一例良性癫痫可完全恢复。60岁以上的患者表现为轻度癫痫。在有症状的癫痫中,病变因素不受演变的影响,致痫病灶稳定而持久。在部分性癫痫中,复杂症状(86%)多于基本症状(14%)。老年癫痫发作的演变与影响复发的所有因素的重要性一起被考虑。
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