DiFrancesco Jacopo C, Labate Angelo, Romoli Michele, Chipi Elena, Salvadori Nicola, Galimberti Carlo Andrea, Perani Daniela, Ferrarese Carlo, Costa Cinzia
Department of Neurology, ASST S. Gerardo Hospital, School of Medicine and Surgery and Milan Center for Neuroscience, University of Milano - Bicocca, Monza, Italy.
Neurophysiopathology Unit, Department of Biomedical and Dental Sciences, Morphological and Functional Images (BIOMORF), University of Messina, Messina, Italy.
Front Neurol. 2022 Feb 25;13:851897. doi: 10.3389/fneur.2022.851897. eCollection 2022.
Epilepsy is classically considered a childhood disease. However, it represents the third most frequent neurological condition in the elderly, following stroke, and dementia. With the progressive aging of the general population, the number of patients with Late-Onset Epilepsy (LOE) is constantly growing, with important economic and social consequences, in particular for the more developed countries where the percentage of elderly people is higher. The most common causes of LOE are structural, mainly secondary to cerebrovascular or infectious diseases, brain tumors, trauma, and metabolic or toxic conditions. Moreover, there is a growing body of evidence linking LOE with neurodegenerative diseases, particularly Alzheimer's disease (AD). However, despite a thorough characterization, the causes of LOE remain unknown in a considerable portion of patients, thus termed as Late-Onset Epilepsy of Unknown origin (LOEU). In order to identify the possible causes of the disease, with an important impact in terms of treatment and prognosis, LOE patients should always undergo an exhaustive phenotypic characterization. In this work, we provide a detailed review of the main clinical and instrumental techniques for the adequate characterization of LOE patients in the clinical practice. This work aims to provide an easy and effective tool that supports routine activity of the clinicians facing LOE.
癫痫传统上被认为是一种儿童疾病。然而，它是老年人中第三常见的神经系统疾病，仅次于中风和痴呆症。随着总人口的逐渐老龄化，晚发性癫痫（LOE）患者的数量在不断增加，这带来了重要的经济和社会后果，特别是在老年人比例较高的发达国家。LOE最常见的病因是结构性的，主要继发于脑血管或感染性疾病、脑肿瘤、创伤以及代谢或中毒情况。此外，越来越多的证据将LOE与神经退行性疾病，特别是阿尔茨海默病（AD）联系起来。然而，尽管进行了全面的特征描述，但在相当一部分患者中，LOE的病因仍然不明，因此被称为不明原因的晚发性癫痫（LOEU）。为了确定该疾病的可能病因，这对治疗和预后有重要影响，LOE患者应始终接受详尽的表型特征描述。在这项工作中，我们对临床实践中充分描述LOE患者特征的主要临床和检查技术进行了详细综述。这项工作旨在提供一个简单有效的工具，以支持面对LOE的临床医生的日常工作。
