Department of Neurology, The First Hospital of Jilin University, Changchun 130021, Jilin, China.
Department of Neurology, The First Hospital of Jilin University, Changchun 130021, Jilin, China.
Seizure. 2021 Jul;89:93-98. doi: 10.1016/j.seizure.2021.05.006. Epub 2021 May 12.
To provide information on the characteristics of elderly epilepsy patients in rural Northeast China.
Consecutive patients (aged >60) who were diagnosed with convulsive epilepsy in seven counties in Jilin Province, Northeast China, between January 2010 and December 2019 were included in the program and were divided into the EOE (early-onset epilepsy) group and the LOE (late-onset epilepsy) group. The patients were followed up once a month, and demographics and clinical data were recorded.
There were 471 patients enrolled in this study, with 329 patients classified into the EOE group and 142 patients recruited into the LOE group. At baseline, the EOE group was younger than the LOE group (t=-9.007, p < 0.001). The most common etiologies for the EOE and LOE groups were post-trauma (4.0%, n=13) and stroke (9.2%, n=13). Elderly epilepsy patients had a good response to PB monotherapy, and no significant difference was found between the two groups (p > 0.05). EOE patients complained of more serious adverse events (p < 0.05), and drowsiness (52%) and ataxia (28%) were the most common adverse events reported by the EOE and LOE groups, respectively; however, more LOE patients were prone to withdrawal due to side effects (p = 0.036). A total of 63 patients withdrew from the study, and nonadherence was the commonest cause for withdrawal (56% in EOE and 50% in LOE). In the entire follow-up period, 112 patients (63 in the EOE group and 49 in the LOE group) died; the most common causes of death were stroke (n=44, 39%) and heart disease (n=36, 32%). The LOE group had a shorter survival time than the EOE group (χ=42.216, p < 0.001). The LOE group (HR=3.47, 95% CI: 2.36-5.09) and higher seizure frequency (HR=1.72, 95% CI: 1.17-2.52) were the risk factors for death.
Elderly epilepsy patients had a good response to PB monotherapy. EOE patients complained of more serious adverse events, but more LOE patients were prone to withdrawal due to side effects. Nonadherence was the commonest cause of drug withdrawal, and it reflects the limited education regarding the impact of seizures and the differences in priorities of rural communities. EOE patients survive longer than LOE patients.
提供中国东北农村老年癫痫患者特征的信息。
纳入 2010 年 1 月至 2019 年 12 月吉林省 7 个县诊断为癫痫发作的连续（年龄>60 岁）患者，分为早发性癫痫（EOE）组和晚发性癫痫（LOE）组。每月对患者进行一次随访，记录人口统计学和临床数据。
本研究共纳入 471 例患者，其中 329 例归入 EOE 组，142 例归入 LOE 组。基线时，EOE 组患者比 LOE 组年轻（t=-9.007，p<0.001）。EOE 和 LOE 两组最常见的病因分别为外伤（4.0%，n=13）和卒中（9.2%，n=13）。老年癫痫患者对 PB 单药治疗反应良好，两组间无显著差异（p>0.05）。EOE 患者报告的不良反应更严重（p<0.05），EOE 和 LOE 两组最常见的不良反应分别为嗜睡（52%）和共济失调（28%）；但由于不良反应，更多的 LOE 患者停药（p=0.036）。共有 63 例患者退出研究，不依从是退出的最常见原因（EOE 组占 56%，LOE 组占 50%）。在整个随访期间，112 例患者（EOE 组 63 例，LOE 组 49 例）死亡；最常见的死亡原因为卒中（n=44，39%）和心脏病（n=36，32%）。LOE 组的生存时间短于 EOE 组（χ=42.216，p<0.001）。LOE 组（HR=3.47，95%CI：2.36-5.09）和更高的发作频率（HR=1.72，95%CI：1.17-2.52）是死亡的危险因素。
老年癫痫患者对 PB 单药治疗反应良好。EOE 患者报告的不良反应更严重，但由于不良反应，更多的 LOE 患者停药。不依从是停药的最常见原因，这反映了农村社区对癫痫发作影响的认知有限，以及优先事项的差异。EOE 患者的生存时间长于 LOE 患者。
