Rohracher Alexandra, Trinka Eugen
Paracelsus Medizinische Privatuniversität Salzburg, Universitätsklinik für Neurologie, Ignaz-Harrer-Str. 79, 5020, Salzburg, Österreich.
Z Gerontol Geriatr. 2021 Jul;54(4):395-408. doi: 10.1007/s00391-021-01882-y. Epub 2021 Apr 23.
Epilepsy is the third most frequent neurological disorder in aged patients after stroke and dementia. The incidence of epilepsy increases with age with the highest rates in patients ≥ 65 years old. Due to demographic changes the number of aged patients with epilepsy is expected to increase further in the coming years. The leading cause of new onset epilepsy in aged patients is cerebrovascular disease followed by dementia. The recognition of seizures in aged patients is often delayed. Status epilepticus occurs more frequently in aged patients and is associated with a high mortality and morbidity. Antiepileptic drug (AED) treatment of aged patients is complicated by comorbidities and polypharmacy and AEDs with a low interaction profile and high tolerability should be selected. Levetiracetam and lamotrigine are the AEDs of choice due to low interactions and good tolerability.
癫痫是老年患者中仅次于中风和痴呆的第三常见神经系统疾病。癫痫的发病率随年龄增长而增加，≥65岁的患者发病率最高。由于人口结构的变化，预计未来几年老年癫痫患者的数量将进一步增加。老年患者新发癫痫的主要原因是脑血管疾病，其次是痴呆。老年患者癫痫发作的识别往往延迟。癫痫持续状态在老年患者中更常见，且与高死亡率和高发病率相关。老年患者的抗癫痫药物（AED）治疗因合并症和多种药物联合使用而变得复杂，应选择相互作用低、耐受性高的AED。左乙拉西坦和拉莫三嗪因其相互作用低且耐受性好，是首选的AED。
