Loiseau J, Loiseau P, Duché B, Guyot M, Dartigues J F, Aublet B
Department of Neurology, University Hospital, Bordeaux, France.
Ann Neurol. 1990 Mar;27(3):232-7. doi: 10.1002/ana.410270304.
An underestimation of epileptic seizures occurring in aged patients is likely. In an epidemiological survey undertaken in Southwest France, the annual incidence rate per 100,000 persons 60 years or older was 127.2 for all seizures (101.3 in persons aged 60 to 69, 150.4 in those aged 70 to 79, and 139.9 in persons 80 years or older). It was 34.1 for symptomatic localization-related and undetermined epilepsies, 16.1 for isolated seizures, and 77.0 for seizures related to an acute situation, such as metabolic derangements, stroke, or head trauma. In this survey, seizures with an onset age of 60 or older represented 28.0% of the confirmed epilepsies, 17.5% of the isolated seizures, and 52.6% of the acute symptomatic seizures. These figures differ dramatically from those in most previous reports concluding that age-specific incidence declined through adult life. They are closer to the data from more recent reports. The main reason for such a high incidence of epileptic seizures in elderly patients is the number of acute symptomatic (or situation-related) seizures. However, even chronic epilepsies increase in frequency in aging persons. Cerebrovascular disease was the most frequently recognized origin (53.9% of the patients with confirmed epilepsies) and brain tumor was found in 32.9% of the patients.
老年患者发生的癫痫发作很可能被低估。在法国西南部进行的一项流行病学调查中，60岁及以上人群每10万人的年发病率为：所有发作类型为127.2（60至69岁人群为101.3，70至79岁人群为150.4，80岁及以上人群为139.9）。症状性定位相关和不明原因癫痫的发病率为34.1，孤立性发作的发病率为16.1，与急性情况（如代谢紊乱、中风或头部创伤）相关的发作的发病率为77.0。在这项调查中，发病年龄在60岁及以上的发作占确诊癫痫的28.0%，孤立性发作的17.5%，急性症状性发作的52.6%。这些数字与大多数先前报告中的数字有很大差异，那些报告得出结论认为特定年龄发病率在成年期会下降。它们更接近近期报告的数据。老年患者癫痫发作发病率如此之高的主要原因是急性症状性（或与情况相关）发作的数量。然而，即使是慢性癫痫在老年人中发作频率也会增加。脑血管疾病是最常见的病因（确诊癫痫患者中有53.9%），32.9%的患者发现有脑肿瘤。
