A Propos d'une éventuelle épilepsie généralisée secondaire tardiveApport de la scanographie cérébrale

Gastaut, H; Michel, Bruno; Gastaut, J. L.; Cerdá, Miguel Jover

doi:10.1016/s0370-4475(80)80010-4

Cited by 5 publications

(2 citation statements)

References 2 publications

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“…In view of the paucity of cerebral tumours and surgically correctable lesions, recent reports have questioned the value of routine CT scanning in late-onset epilepsy"' 9 ' 20 but this is controversial. 9 The majority of patients have a normal CT scan and the presence of cerebral atrophy although common, seems to be without particular diagnostic or prognostic influence. Cerebrovascular disease appears to be the most frequently identified cause of late-onset epilepsy although the exact causal relationships require further study.…”

Section: '"mentioning

confidence: 99%

CT Findings in Late-Onset Epilepsy

Sayette

Cosgrove

Melanson

et al. 1987

Can. j. neurol. sci.

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We reviewed the CT findings of 387 patients with new-onset seizures after the age of 50. Seizures were generalized in 212 patients, focal in 160, and indeterminant in 15. CT scanning revealed cerebral atrophy in 113 cases, ischemic lesions in 75, cerebral neoplasms in 20, and no abnormality in 177 cases. Tumours were found in only three patients with generalized seizures, and all three had focal neurological deficits at the time of CT diagnosis, while 17 neoplasms were discovered in patients with a focal seizure disorder. The majority of patients with late-onset epilepsy have a normal CT scan with cerebral atrophy being the most common abnormality detected. Cerebral vascular disease appears to be the most frequently identified cause of late-onset epilepsy, while cerebral neoplasms are uncommon. RESUME: Constatations au CT scan dans Pepilepsie d'apparition tardive. Nous avons revu 387 CT scans de patients, age de 50 ans et plus, souffrant d'epilepsie de novo. Les crises etaient generalisees chez 212 patients, focales chez 160 et de nature indeterminee chez 15. Outre l'age et le caractere recent de l'6pilepsie, les patients retenus pour cette etude etaient exempts de tout antecedent neurologique ou neurochirurgical. Sur les 387 patients selectionn6s, 113 presentaient une atrophie cerebrale, 75 des lesions vasculaires, 20 des neoplasies et enfin 177 ne presentaient aucune anomalie. La presence de tumeur fut relevee seulement chez 3 patients souffrant d'epilepsie generalisee et tous 3 presentaient un deficit neurologique lors de l'etude par CT, alors que 17 neoplasies ont ete decouvertes chez les patients presentant une epilepsie focale. La majorite des patients souffrant d'epilepsie apres 50 ans ont un CT normal, l'atrophie cerebrale y etant l'anomalie la plus communement rencontree. Une maladie cerebrovasculaire apparait etre la cause la plus frequemment identified dans l'emergence de l'epilepsie tardive (50 ans et plus), alors que les neoplasies sont plutot rares.Can. J. Neurol. Sci. 1987; 14:286-289 Epilepsy beginning in late adult life is uncommon 1 but may be caused by a variety of disorders including cerebrovascular disease, brain tumours, degenerative and inflammatory cerebral processes or metabolic disturbances. However, only limited information is available concerning the clinical characteristics and causes of late-onset epilepsy. The importance of establishing an etiological diagnosis and excluding an expanding intracerebral lesion as the cause of the seizure is well accepted. In addition to clinical and electrophysiological data, computed tomography (CT) is commonly employed to investigate epilepsy in the elderly. We have reviewed the clinical and CT findings of 387 elderly patients (older than 50) with new-onset seizures in an attempt to establish clinical and radiological correlations in late-onset epilepsy and to examine the role of CT scanning in this condition. MATERIALS AND METHODSIn a review of the radiological files of the Montreal Neurological Hospital from 1978 to 1984, we found 38...

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Section: '"mentioning

confidence: 99%

CT Findings in Late-Onset Epilepsy

Sayette

Cosgrove

Melanson

et al. 1987

Can. j. neurol. sci.

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“…Recep tor sensitivity changes are responsible for both adverse effects in the elderly [20] and withdrawal phenomena in general [21], In withdrawal states receptor change is mainly limited to a transient subsensitivity of the GABA-ergic system, in the elderly it is a more permanent, diffuse and less specific dysfunction due to altered neuronal metabo lism and/or cell loss. One in 5 elderly pa tients suffering from late-onset 'secondary' generalized epilepsy related to cerebral atro phy shows a prominent history of alcohol abuse [22], To our knowledge it has not been shown that this situation is essentially differ ent in late-onset partial seizures with or without generalization. On the contrary, al cohol abuse has recently been documented in 25% of late-onset seizures as the main etiological factor [23].…”

Section: Sweden/hosiementioning

confidence: 84%

Are Complex Partial Seizures an Uncommon Withdrawal Sign in the Elderly?

Sweden

Hoste²

1987

Eur Neurol

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An elderly female alcohol and benzodiazepine addict presented with an atypical amnestic episode. Five days later she showed several complex partial seizures as main signs of a withdrawal state. The value of the EEG in the differential diagnosis of amnestic syndromes is emphasized. Temporolimbic involvement in withdrawal states is discussed and our ignorance regarding drug dependence and withdrawal in the elderly is stressed. It is suggested that late-onset partial seizures with unknown etiology in the elderly might be more often related to drug dependence than generally accepted.

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A survey of epileptic disorders in Southwest France: Seizures in elderly patients

Loiseau

Duché

et al. 1990

Annals of Neurology

183

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An underestimation of epileptic seizures occurring in aged patients is likely. In an epidemiological survey undertaken in Southwest France, the annual incidence rate per 100,000 persons 60 years or older was 127.2 for all seizures (101.3 in persons aged 60 to 69, 150.4 in those aged 70 to 79, and 139.9 in persons 80 years or older). It was 34.1 for symptomatic localization-related and undetermined epilepsies, 16.1 for isolated seizures, and 77.0 for seizures related to an acute situation, such as metabolic derangements, stroke, or head trauma. In this survey, seizures with an onset age of 60 or older represented 28.0% of the confirmed epilepsies, 17.5% of the isolated seizures, and 52.6% of the acute symptomatic seizures. These figures differ dramatically from those in most previous reports concluding that age-specific incidence declined through adult life. They are closer to the data from more recent reports. The main reason for such a high incidence of epileptic seizures in elderly patients is the number of acute symptomatic (or situation-related) seizures. However, even chronic epilepsies increase in frequency in aging persons. Cerebrovascular disease was the most frequently recognized origin (53.9% of the patients with confirmed epilepsies) and brain tumor was found in 32.9% of the patients.

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A Propos d'une éventuelle épilepsie généralisée secondaire tardiveApport de la scanographie cérébrale

Cited by 5 publications

References 2 publications

CT Findings in Late-Onset Epilepsy

CT Findings in Late-Onset Epilepsy

Are Complex Partial Seizures an Uncommon Withdrawal Sign in the Elderly?

A survey of epileptic disorders in Southwest France: Seizures in elderly patients

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