University Hospital Erlangen, Epilepsy Center, Germany.
Acta Neurol Scand. 2011 Oct;124(4):223-37. doi: 10.1111/j.1600-0404.2010.01464.x. Epub 2010 Dec 10.
The incidence of epilepsy in the elderly has increased steadily over the last few decades. In some industrialized countries, one-third of the population is expected to be over the age of 65 in 2030. Therefore, we will face a dramatic increase in the number of elderly patients with epilepsy, many of whom will likely present comorbidities. This increase will put a heavy burden on health care and pension systems. This article focuses on epidemiology, diagnosis and treatment in epilepsies in the elderlies and outlines current research as well as future requirements for research. The diagnosis of epilepsy in the elderly can be difficult and may require long-term video-EEG monitoring. Stroke is the most frequent etiology in epilepsies in the elderlies. Status epilepticus in acute symptomatic epilepsies often results in fatality and may become an increasing health problem. The article also describes the current strategies in antiepileptic drug treatment and epilepsy surgery in the elderly. Novel antiepileptic drugs are necessary as current antiepileptics have strong interaction potentials and harmful side effects, making them ill-suboptimal for treating epilepsy in the elderly.
在过去几十年中，老年人癫痫的发病率稳步上升。在一些工业化国家，预计到 2030 年，三分之一的人口年龄将超过 65 岁。因此，我们将面临老年癫痫患者数量的急剧增加，其中许多患者可能伴有合并症。这一增长将给医疗保健和养老金系统带来沉重负担。本文重点介绍老年人癫痫的流行病学、诊断和治疗，并概述了当前的研究以及未来对研究的要求。老年人癫痫的诊断可能很困难，可能需要长期视频脑电图监测。中风是老年人癫痫中最常见的病因。急性症状性癫痫持续状态常导致死亡，可能成为日益严重的健康问题。本文还描述了老年人中抗癫痫药物治疗和癫痫手术的当前策略。由于现有抗癫痫药物具有较强的相互作用潜力和有害的副作用，因此需要新型抗癫痫药物，使其不太适合治疗老年人的癫痫。
