Abstract
ObjectiveTo describe the clinical characteristics of elderly patients with new-onset epilepsy in a Class A tertiary comprehensive hospital in north China and evaluate the treatment outcomes of antiseizure medications (ASMs). This study focuses on investigating the factors affecting the treatment outcomes, guiding the drug treatment, and judging the prognosis of elderly epilepsy patients.MethodsWe included patients aged 60 years or older at the time of their first seizure between January 2014 and August 2020. Demographic characteristics, effects of ASM, and the proportion of 1-year and long-term seizure freedom were reported. The univariate analysis and binary logistic regression were used to identify factors potentially influencing treatment outcomes.ResultsA total of 326 patients (median age 65 years, 67.2% men) were included. Moreover, 185 (56.7%) patients who received the first ASM monotherapy achieved 1 year of seizure freedom in the early stage. Compared with structural etiology, unknown etiology was associated with a higher likelihood of early seizure freedom (odds ratio [OR] = 0.545; p < 0.05). Conversely, comorbid intracranial malignant tumors, taking carbamazepine (CBZ), and sodium valproate (VPA) were associated with a lower likelihood of seizure freedom (OR = 3.527 vs. 6.550 vs. 8.829; p < 0.05). At long-term follow-up, 263 (80.6%) patients achieved seizure freedom, with 79.8% on monotherapy.ConclusionsElderly patients with new-onset epilepsy responded well to the initial ASMs treatment. Patients with intracranial malignant tumors and prescribed VPA and CBZ were less likely to achieve early seizure freedom, while those with unknown etiology had higher probabilities of achieving early seizure freedom than those with structural etiology.
Highlights
With the aging of the population, the incidence of elderly epilepsy is significantly higher than that of any other age group [1], and the economic burden on individuals and the healthcare system continues to increase
This paper described the clinical characteristics of elderly patients with new-onset epilepsy in our center, evaluated the treatment outcomes of different antiseizure medication (ASM), and investigated factors that affect the outcomes of the treatment, aiming to find more reasonable management regimens for elderly patients with new-onset epilepsy
Structural etiology accounted for the highest proportion, followed by unknown etiology
Summary
With the aging of the population, the incidence of elderly epilepsy is significantly higher than that of any other age group [1], and the economic burden on individuals and the healthcare system continues to increase. Data published in the past few years have identified several risk factors related to the prognosis of adult epilepsy. Factors, such as the number of seizures before treatment, complex partial seizures, the etiology of abnormal brain structure, longer initial treatment time, depression, and abnormal brain imaging were related to the adverse treatment outcomes of epilepsy [3–7], but most of the studies were conducted in the whole or adult population. This paper described the clinical characteristics of elderly patients with new-onset epilepsy in our center, evaluated the treatment outcomes of different ASMs, and investigated factors that affect the outcomes of the treatment, aiming to find more reasonable management regimens for elderly patients with new-onset epilepsy
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