Clinical features and courses in patients with new-onset epileptic convulsive seizure: Comparison of elderly with non-elderly

We retrospectively studied the clinical features and the outcome of first acute symptomatic seizure in elderly. The subjects were 457 patients, who were more than 15 years old, and whose electroencephalograms were available in our hospital. The subjects were divided into two groups, the elderly (236 patients; age more than 60 years, mean age; 73.2±8.2, 105 female, 131 men), and non-elderly (221 patients; 15≤age≤59, mean age; 35.7±14.1, 87 female, 134 men), and were diagnosed in accordance with the guidelines of ILAE. We ascertained all episodes of acute symptomatic seizure and unprovoked seizure. Date on age, gender, etiology, status epilepticus (SE), 30-day and one-year mortalities, and subsequent episodes of unprovoked seizure were collected. Acute symptomatic seizures are more likely to occur in elderly group, and showed higher short-/and long-term mortalities than unprovoked seizures in both elderly and non-elderly groups. Acute symptomatic seizures due to multiple causes in elderly group showed the highest mortality. The outcome of patient who had SE was poorer within 30 days, but not within one year among 30-day survivors. Considering the fact that first seizures in the elderly are likely to be provoked by acute illnesses, we need to take special care in diagnosing and treating them.