Comparison of new-onset and persistent epilepsy in the elderly.

Abstract

Previous studies on elderly epilepsy included only patients with new-onset disease, but there are many patients who developed epilepsy earlier and aged. We compared the characteristics of new-onset and persistent epilepsy in the elderly. We performed a 10-year retrospective analysis of elderly patients with epilepsy divided into two groups according to the onset of seizure: new-onset epilepsy (onset age ≥65) and persistent epilepsy (onset age<65). Nearly half (78/172, 45.3%) of patients in the new-onset group presented as status epilepticus, and one-fourth of these (19/78, 24.4%) died during the initial treatment for status epilepticus. Patients in the new-onset epilepsy group presented more frequently as status epilepticus (59/153 vs 12/78, P<0.001) and had a past history of status epilepticus (63/153 vs 20/78, P=0.02). History of stroke (81/153 vs 30/78, P=0.04), hypertension (83/153 vs 29/78, P=0.01), and dyslipidemia (53/153 vs 17/78, P=0.05) was more common in the new-onset group, but patients in the persistent group used more antiepileptic drugs (AEDs; P=0.036) and total AED drug loads (P=0.028). Our study shows that new-onset epilepsy has a higher incidence of status epilepticus and more stroke-related risk factors but may require fewer AEDs for epilepsy control.