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老年癫痫患者。

Elders with epilepsy.

作者信息

Collins Nancy S, Shapiro Rita A, Ramsay R Eugene

机构信息

Department of Neurology, Rosalind Franklin University of Medicine and Science/Chicago Medical School, 3333 Green Bay Road, North Chicago, IL 60064, USA.

出版信息

Med Clin North Am. 2006 Sep;90(5):945-66. doi: 10.1016/j.mcna.2006.06.002.

Abstract

Why is it important to learn about epilepsy in the elderly? The answers are many. As this article has highlighted, compared with younger individuals epilepsy is more common and the causes are more structural and symptomatic than in younger patients (particularly stroke). The clinical presentation is different in the elderly. The diagnosis is more difficult and often delayed. The most common seizures are simple partial and complex partial seizures, which are more often extratemporal in location. Confusion and memory problems are common presenting symptoms and postictal deficits often are prolonged. The prognosis for epilepsy in the elderly generally is favorable for seizure control, but if untreated, depression and quality of life suffer and seizures frequently recur. Seizures respond well at lower serum concentrations of antiepileptic drugs but these patients are also more sensitive (less tolerant) to side effects at lower doses than younger adults.

摘要

为什么了解老年癫痫很重要?答案有很多。正如本文所强调的,与年轻人相比,癫痫在老年人中更为常见,其病因比年轻患者更多为结构性和症状性(尤其是中风)。老年人的临床表现有所不同。诊断更加困难且常常延迟。最常见的发作类型是简单部分性发作和复杂部分性发作,其发作部位更多在颞叶外。意识模糊和记忆问题是常见的症状表现,发作后缺损往往会持续较长时间。老年癫痫的预后一般有利于控制发作,但如果不进行治疗,会出现抑郁情绪,生活质量下降,且癫痫频繁复发。抗癫痫药物在较低血清浓度时对发作就有良好疗效,但这些患者在较低剂量时对副作用也比年轻人更敏感(耐受性更低)。

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