Terzano M G, Mancia D, Zacchetti O, Manzoni G C
Riv Patol Nerv Ment. 1981 Jul-Aug;101(4):185-201.
In a group of 657 epileptic patients there were 51 presenting with fits even after having reached the age of 60. The onset of seizures dated back to the first 20 years in 15 patients between 20 and 40 years in 15 and between 40 and 60 years in 21. In 67% of the cases it was possible to determine the cause of seizures. The aetiology was unevenly distributed within each group. In the first group (up to 20 years) the P.G.E. forms prevail. In the second (up to 40 years) post traumatic epilepsy and inflammatory processes were predominant, while in the third (up to 60 years) vascular and tumoral pathology seem to be prevalent. 43% of the patients showed paroxysmal abnormalities in the EEG and these were still present even after to age of 60 years in more than fifty per cent. After the age of 60 we found no case of benign epilepsy amenable to complete recovery. Patients older than 60 present epilepsies of mild severity. In symptomatic epilepsies the lesional factors were not subject to evolution and the epileptogenic focuses were stable and persistent. In partial epilepsy there were more cases of complex symptomatology (86%) than cases of elementary symptomatology (14%) The evolution of seizures in old age is considered together with the importance of all factors influencing recurrency.
在一组657例癫痫患者中,有51例即使到了60岁仍有发作。癫痫发作起始于20岁之前的有15例,20至40岁之间的有15例,40至60岁之间的有21例。在67%的病例中能够确定癫痫发作的原因。病因在每组中分布不均。在第一组(20岁之前),以P.G.E.形式为主。在第二组(40岁之前),创伤后癫痫和炎症过程占主导,而在第三组(60岁之前),血管和肿瘤性病变似乎较为普遍。43%的患者脑电图显示阵发性异常,其中超过50%的患者即使到了60岁仍有异常。60岁之后,未发现可完全康复的良性癫痫病例。60岁以上的患者癫痫症状较轻。在症状性癫痫中,病变因素不会演变,致痫灶稳定且持续存在。在部分性癫痫中,复杂症状学的病例(86%)多于基本症状学的病例(14%)。老年癫痫发作的演变与影响复发的所有因素的重要性一并考虑。