Kotloski Robert J, Dowding Jessie, Hermann Bruce P, Sutula Thomas P
Department of Neurology, William S Middleton Memorial Veterans Hospital, Madison, WI, United States; Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Handb Clin Neurol. 2019;167:455-475. doi: 10.1016/B978-0-12-804766-8.00025-X.
The intersection of epilepsy and aging has broad, significant implications. Substantial increases in seizures occur both in the elderly population, who are at a higher risk of developing new-onset epilepsy, and in those with chronic epilepsy who become aged. There are notable gaps in our understanding of aging and epilepsy at the basic and practical levels, which have important consequences. We are in the early stages of understanding the complex relationships between epilepsy and other age-related brain diseases such as stroke, dementia, traumatic brain injury (TBI), and cancer. Furthermore, the clinician must recognize that the presentation and treatment of epilepsy in the elderly are different from those of younger populations. Given the developing awareness of the problem and the capabilities of contemporary, multidisciplinary approaches to advance understanding about the biology of aging and epilepsy, it is reasonable to expect that we will unravel some of the intricacies of epilepsy in the elderly; it is also reasonable to expect that these gains will lead to further improvements in our understanding and treatment of epilepsy for all age groups.
癫痫与衰老的交叉领域具有广泛而重大的意义。在老年人群中，新发癫痫的风险较高，癫痫发作大幅增加；而在患有慢性癫痫的人群步入老年时，癫痫发作也会显著增多。在基础和实际层面，我们对衰老与癫痫的认识存在明显差距，这产生了重要影响。我们尚处于理解癫痫与其他与年龄相关的脑部疾病（如中风、痴呆、创伤性脑损伤（TBI）和癌症）之间复杂关系的早期阶段。此外，临床医生必须认识到，老年人癫痫的表现和治疗与年轻人群不同。鉴于对该问题的认识不断提高，以及当代多学科方法有能力推动对衰老和癫痫生物学的理解，我们有理由期待能够解开老年人癫痫的一些复杂谜团；同样有理由期待这些成果将进一步改善我们对所有年龄组癫痫的理解和治疗。
