Tilz Christian
Klinik für Neurologie, Epileptologie, Krankenhaus Barmherzige Brüder Regensburg.
Dtsch Med Wochenschr. 2022 Jun;147(11):669-675. doi: 10.1055/a-1664-1338. Epub 2022 May 30.
The incidence rate of epilepsy has importantly increased during the last decades due to the rising expectation of life. Special clinical aspects have to be considered for the correct diagnosis and differential diagnosis of epileptic seizures in the elderly: On one hand, the etiology of epilepsy in the elderly is different from epilepsies of younger people with a higher rate of symptomatic epilepsies compared to younger people. On the other hand, seizures are more often clinically inconclusive as they frequently appear without motor symptoms and therefore require an accurate diagnostic differentiation from other attacks of unconsciousness. The most accurate diagnostic tool for the correct diagnosis of such seizures is the registration of the seizures by longtime-video-EEG-monitoring (LTVEM). If LTVEM cannot be performed also home-video-registration could be useful. Medical treatment of epilepsies in the elderly has to be done with special consideration of comorbidity and metabolic changes in this age group.
在过去几十年中,由于预期寿命的增加,癫痫的发病率显著上升。对于老年人癫痫发作的正确诊断和鉴别诊断,必须考虑特殊的临床方面:一方面,老年人癫痫的病因与年轻人不同,与年轻人相比,症状性癫痫的发生率更高。另一方面,癫痫发作在临床上往往缺乏定论,因为它们经常在没有运动症状的情况下出现,因此需要与其他意识丧失发作进行准确的诊断鉴别。对于此类癫痫发作正确诊断的最准确诊断工具是通过长时间视频脑电图监测(LTVEM)记录发作情况。如果无法进行LTVEM,家庭视频记录也可能有用。老年人癫痫的药物治疗必须特别考虑该年龄组的合并症和代谢变化。