LaRoche Suzette M, Helmers Sandra L
Department of Neurology, Emory University, Altanta, GA 30322, USA.
Neurologist. 2003 Sep;9(5):241-9. doi: 10.1097/01.nrl.0000087719.64343.be.
Epilepsy is one of the most common neurologic diseases that affect the elderly population. Underlying etiologies as well as diagnostic and treatment issues vary from that of younger adults and deserve special consideration.
The substantially increased risk of seizures and epilepsy in the elderly is associated with medical conditions that affect this group such as stroke, dementia, and metabolic disturbances. In addition, there is an increased incidence and associated mortality of status epilepticus among seniors. Distinguishing epilepsy from paroxysmal nonepileptic events can be a particular challenge. As in the general adult population, EEG and MRI are the cornerstones of diagnostic assessment; however, the clinician must be aware of nonspecific changes associated with aging that do not necessarily indicate an underlying predisposition for epilepsy. Finally, there are unique challenges to the treatment of epilepsy in this population, but fortunately there are multiple treatment options available, including nonpharmacological therapies.
Knowledge of the unique challenges in identifying and treating the elderly patient with epilepsy is important for effective management as well as maximizing quality of life. However, further studies in this area are still needed to establish optimal treatment strategies.
癫痫是影响老年人群的最常见神经系统疾病之一。其潜在病因以及诊断和治疗问题与年轻成年人不同，值得特别关注。
老年人癫痫发作和患癫痫的风险大幅增加与影响该群体的疾病有关，如中风、痴呆和代谢紊乱。此外，老年人癫痫持续状态的发病率和相关死亡率也有所上升。将癫痫与阵发性非癫痫性事件区分开来可能是一项特殊挑战。与一般成年人群一样，脑电图（EEG）和磁共振成像（MRI）是诊断评估的基石；然而，临床医生必须意识到与衰老相关的非特异性变化，这些变化不一定表明存在癫痫的潜在易感性。最后，该人群癫痫治疗存在独特挑战，但幸运的是有多种治疗选择，包括非药物疗法。
了解识别和治疗老年癫痫患者的独特挑战对于有效管理以及提高生活质量非常重要。然而，该领域仍需要进一步研究以确立最佳治疗策略。
