Cao Zhen, Li Yinping, Liu Shengyi, He Zihua, Li Jinmei
Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Geriatric, The Second People's Hospital of Yibin, Yibin, 644000, China.
Acta Epileptol. 2024 Apr 1;6(1):11. doi: 10.1186/s42494-024-00153-8.
Senile epilepsy and its comorbidities pose a tremendous burden on patients and the society. This study was aimed to investigate the clinical characteristics and comorbidities of senile epilepsy, as well as the impact of comorbidities on the prognosis of senile epilepsy.
Information of patients with senile epilepsy was retrospectively collected from three tertiary hospitals in Southwest China between December 2014 and December 2022. A total of 154 patients met the inclusion criteria and were divided into two groups based on the presence or absence of comorbidities. The prevalence, type, characteristics, and impacts of the comorbidities were investigated. The characteristics of patients with and without comorbidities were also compared.
Eighty-one percent of patients with senile epilepsy had at least one comorbidity, and 36% had three or more comorbidities. Eighteen different types of comorbidities were identified. The most common comorbidities were neurological (61%), followed by cardiovascular (45%) and psychiatric (26%) comorbidities. More than one-third of patients had bidirectional comorbidities, whereas more than half of the patients had additional causal comorbidities. Among all types of comorbidities, neurological and psychiatric comorbidities were found to be associated with an increased risk of recurrent seizures. Compared to patients without bidirectional comorbidities, those with at least one bidirectional comorbidity had a lower rate of achieving seizure freedom. The higher the number of bidirectional comorbidities, the lower the seizure-free rate. Survival analysis revealed that patients with neurological comorbidities had a higher risk of death.
This study revealed a high comorbidity rate and a low seizure-freedom rate among patients with senile epilepsy. In particular, neuropsychiatric comorbidities can increase the risk of seizures and affect the survival rate of patients with senile epilepsy. Therefore, preventing and managing these comorbidities may improve seizure outcomes and reduce mortality in this special population.
老年癫痫及其合并症给患者和社会带来了巨大负担。本研究旨在调查老年癫痫的临床特征和合并症，以及合并症对老年癫痫预后的影响。
回顾性收集2014年12月至2022年12月期间中国西南地区三家三级医院老年癫痫患者的信息。共有154例患者符合纳入标准，并根据是否存在合并症分为两组。对合并症的患病率、类型、特征及影响进行调查。同时比较有合并症和无合并症患者的特征。
81%的老年癫痫患者至少有一种合并症，36%的患者有三种或更多合并症。共识别出18种不同类型的合并症。最常见的合并症是神经系统疾病（61%），其次是心血管疾病（45%）和精神疾病（26%）。超过三分之一的患者有双向合并症，而超过一半的患者有额外的因果合并症。在所有类型的合并症中，神经系统和精神系统合并症被发现与癫痫复发风险增加有关。与无双向合并症的患者相比，至少有一种双向合并症的患者达到无癫痫发作的比例较低。双向合并症的数量越多，无癫痫发作率越低。生存分析显示，有神经系统合并症的患者死亡风险更高。
本研究揭示老年癫痫患者合并症发生率高，无癫痫发作率低。特别是，神经精神合并症会增加癫痫发作风险，并影响老年癫痫患者的生存率。因此，预防和管理这些合并症可能会改善癫痫发作结局，并降低这一特殊人群的死亡率。
