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April2012 Vol.49 Issue:        2        Table of Contents
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Clinical Presentation and Aetiology of First-ever Seizures in Hospital-based Elderly Patients

Hala M. El-Khawas

Department of Neurology, Ain Shams University; Egypt



Background: There is increasing evidence that the prevalence of new-onset epilepsy is quite high among the elderly. Frequently, it is difficult to establish the diagnosis of epilepsy in the older individual, as most seizures in elderly patients are misdiagnosed as mental changes. Objective: Is to study the possible causes and clinical characteristics of seizures in elderly population. Methods: The study included 73 patients who developed epilepsy after the age of 60 years. All the patients were subjected to: Detailed history, full physical and neurological examination, laboratory investigations, routine EEG, and Brain MRI. Results: Seventy three patients were included in this study; their mean age was 70.77+_9.14 years (range 61-96 years). Nine patients (12.3%) presented with partial seizures, while 24 patients (32.8%) had partial seizures with secondary generalization. Generalized tonic-clonic seizures were found in 27 (37%) of the patients, while 13 (17.8%) presented with status epilepticus. Vascular cause was the aetiology of seizures in 37 (50.7%) of cases. Brain tumours were found in four cases (5.5%) and posttraumatic seizures were in 2 cases (2.7%), while CNS infection was present in one patient. No identifiable aetiology was found in 29 (39.7%) of our cases. EEG abnormalities were met in 57 patients (78.1%) while MRI was abnormal in 64 patients (87.7%). Normal MRI was found in 9 patients out of them, EEG was abnormal in only 6 patients. Conclusion: The most common aetiology for seizures in the elderly is cerebrovascular, primarily ischemic and the commonest clinical presentation is generalized tonic clonic. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(2): 137-142]

Key words: Epilepsy, Elderly, First-ever, Clinical presentation.

Correspondence to Hala M. El-Khawas, Department of Neurology, Ain Shams University, Egypt. Tel.; +01005297952. Email:

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