Kawai Makoto, Hrachovy Richard A, Franklin Peggy J, Foreman Perry J
Peter Kellaway Section of Neurophysiology, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
J Clin Neurophysiol. 2007 Dec;24(6):429-32. doi: 10.1097/WNP.0b013e31815ba0c8.
Video-EEG monitoring is a standard tool to evaluate possible seizures. However, there are limited data available for the elderly population, and no data are available for the elderly veteran population. The records of 71 veterans ages 60 and older who underwent video-EEG monitoring at the Michael E. DeBakey Veterans Affairs Medical Center from 1999 to 2006 were reviewed. The average age was 68 years, and 94% were male. Typical events occurred in 34 of 71 patients (48%). Twelve patients (35%) had epileptic seizures; most were temporal lobe seizures (75%). The remaining 22 patients (65%) had a nonepileptic event. Of these, 10 (45%) had psychogenic nonepileptic seizures and 12 (55%) had other physiologic nonepileptic events. AEDs were previously prescribed in 14 of the 22 nonepileptic patients (64%). In our study, most events were nonepileptic, partly reflecting the unique nature of the VA population. There was a slightly higher number of physiologic nonepileptic events; however, psychogenic seizures are also frequently seen. Most of the patients with nonepileptic events were previously treated with AEDs. Most of the epileptic events captured were temporal lobe seizures. Video-EEG monitoring in the elderly is useful in the characterization of paroxysmal events.
视频脑电图监测是评估可能发生的癫痫发作的标准工具。然而，针对老年人群的相关数据有限，而关于老年退伍军人的此类数据则完全缺失。我们回顾了1999年至2006年间在迈克尔·E·德贝基退伍军人事务医疗中心接受视频脑电图监测的71名60岁及以上退伍军人的记录。这些患者的平均年龄为68岁，其中94%为男性。71名患者中有34名（48%）出现了典型事件。12名患者（35%）发生了癫痫发作；其中大部分为颞叶癫痫发作（75%）。其余22名患者（65%）出现了非癫痫性事件。在这些非癫痫性事件中，10名（45%）为心因性非癫痫性发作，12名（55%）为其他生理性非癫痫性事件。在22名非癫痫性患者中，有14名（64%）之前曾被开具抗癫痫药物（AEDs）。在我们的研究中，大多数事件为非癫痫性的，这在一定程度上反映了退伍军人这一群体的独特性质。生理性非癫痫性事件的数量略多一些；不过，心因性癫痫发作也较为常见。大多数发生非癫痫性事件的患者之前都接受过抗癫痫药物治疗。所捕捉到的癫痫性事件大多为颞叶癫痫发作。对老年人进行视频脑电图监测有助于对阵发性事件进行特征描述。
