Epidemiological and medical aspects of epilepsy in the elderly
Epidemiological and medical aspects of epilepsy in the elderly
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DOI：
10.1016/j.eplepsyres.2005.07.016
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发表时间：
2006-01-01
影响因子：
2.2
通讯作者：
Walczak, T
中科院分区：
文献类型：
--
作者：
Cloyd, J;Hauser, W;Walczak, T
老年人中癫痫的发病率和患病率均较高。脑血管疾病是最常见的潜在病因，尽管多达 25-40% 的老年人新发癫痫病例没有明显的潜在病因。癫痫持续状态似乎在 60 岁以上的个体中更常见，并且该年龄组的癫痫持续状态的发病率和死亡率显着更高。老年癫痫患者，尤其是复杂部分性癫痫发作，其表现与年轻人不同，这可能导致误诊。老年患者的发作后意识混乱可能持续长达 1-2 周，而年轻人则只有几分钟。不良事件在症状上相似，但在老年患者中更常见，并且发生在较低的剂量和血浆药物浓度下。抑郁症和焦虑症等神经精神疾病在老年癫痫患者中很常见，但往往诊断不足且治疗不充分。服用抗癫痫药物的老年女性患骨质疏松症的风险很高，这凸显了评估该群体骨骼健康和治疗的重要性。老年癫痫患者的治疗需要了解该年龄组特有的病因以及医学和心理方面。 (c) 2005 年 Elsevier B.V. 出版
Both the incidence and prevalence of epilepsy are high among the elderly. Cerebrovascular disease is the most common underlying cause, although as many as 25-40% of new epilepsy cases in the elderly have no obvious underlying etiology. Status epilepticus appears to occur more frequently in individuals greater than 60 years, and the morbidity and mortality of status epilepticus are significantly greater in this age group. Elderly patients with seizures, particularly complex partial seizures, present differently than younger adults, which can lead to misdiagnosis. Post-ictal confusion may last as long as 1-2 weeks in an elderly patient, as opposed to minutes in younger individuals. Adverse events are similar in symptomatology, but are more common in elderly patients and occur at lower doses and plasma drug concentrations. Neuropsychiatric disorders, such as depression and anxiety, are common in elderly patients with epilepsy, although often under-diagnosed and inadequately treated. The risk of osteoporosis is high among elderly women taking antiepileptic drugs, which underscores the importance of assessing bone health and treatment in this group. Management of the older patient with epilepsy requires an understanding of the etiologies and the medical and psychological aspects unique to this age group. (c) 2005 Published by Elsevier B.V.