Epilepsy in patients 60 years and above

OBJECTIVE: To evaluate the clinical characteristics and etiology of epilepsy at age 60 years and above in the Western Region of Saudi Arabia (KSA), as epilepsy is now considered to be the third most frequent neurological problem in the elderly population.

METHODS: We retrospectively reviewed the medical records of patients 60 years and above at King Khalid National Guard Hospital, Jeddah, KSA between 1999 and 2007 with new onset of seizures and diagnosed as suffering from epilepsy. We excluded patients 60 and above with provoked seizures.

RESULTS: Seventy-five patients of late onset epilepsy were studied. Partial seizure (focal) was found in 40 patients (53.3%); generalized tonic clonic seizures in18 patients (24%); unclassified seizure in 13 patients(17.5%); and status epilepticus in 4 patients (5.3%). Stroke was the underlying etiology in 52 patients(69.3%); brain tumor was found in 8 patients(10.7%), trauma in 3 patients (4%), and infection in3 patients (4%). None of the patients had a family history of epilepsy. No cause (idiopathic) was found in 9 (12%) patients.

CONCLUSION: The most common type of epilepsy at age 60 and above in our study is symptomatic epilepsy with stroke as the leading cause. Modifying risk factors for stroke such as: hypertension, diabetes mellitus, and high cholesterol may reduce the incidence of epilepsy in this age group.