Alberca R, Moreno A
Servicio de Neurologia, Hospital Universitario Virgen del Rocío, Sevilla.
Neurologia. 1996 Dec;11 Suppl 4:72-9.
Epileptic seizures appearing in adulthood are not uncommon. They are usually provoked or involve acute symptoms, but late-onset unprovoked seizures are also frequent. The chance of repeated seizures is high, and when they occur late-onset epilepsy (LOE) is diagnosed. The incidence of LOE, particularly in the elderly, has increased over the past ten years. The etiology of this entity depends to a great extent on age. Idiopathic LOE is quite frequent, especially in the young adult and new epileptic syndromes have recently been described. The percentage of LOE cases attributable to tumors and traumatism is high in the middle-aged adult. Vascular disease and dementia are the main causes of LOE in the elderly. The treatment of LOE follows the general guidelines, but the starting drug doses must be lower and certain antiepileptic must be avoided in the elderly. Seizures are often controlled by a single drug given at comparatively low doses. New longitudinal studies are needed, however, to allow us to formulate new rational therapeutic approaches.
成年期出现的癫痫发作并不罕见。它们通常由某些因素诱发或伴有急性症状，但迟发性特发性癫痫发作也很常见。癫痫复发的几率很高，一旦出现迟发性癫痫发作（LOE），即可确诊。在过去十年中，LOE的发病率，尤其是在老年人中，有所上升。该疾病的病因在很大程度上取决于年龄。特发性LOE相当常见，尤其是在年轻成年人中，并且最近有新的癫痫综合征被描述。在中年成年人中，由肿瘤和创伤引起的LOE病例所占比例较高。血管疾病和痴呆是老年人LOE的主要原因。LOE的治疗遵循一般指南，但起始药物剂量必须较低，并且老年人必须避免使用某些抗癫痫药物。癫痫发作通常通过相对低剂量的单一药物来控制。然而，需要新的纵向研究，以便我们制定新的合理治疗方法。
