中老年初发癫痫的临床和脑电图特点

Clinical and EEG features of new-onset epilepsy in quinquagenarian people

目的探讨中老年初发癫痫患者的临床表现和脑电图特点等。方法回顾分析2015年9月-2016年12月≥55岁初发癫痫患者的临床和脑电图数据。结果(1)颞叶癫痫(n=23,31.1%)最常见。病因脑梗死(n=17,23.0%)、腔隙性脑梗死(n=16,21.6%)多见。发作间期视频脑电图61.6%(n=45)可监测到癫痫样放电,其中59.2%位于颞叶。53.1%患者影像学资料提示存在结构性损害,40.6%仅表现为非特异性改变;(2)中年组(55岁≤年龄<65岁)和老年组(年龄≥65岁)在病因海马硬化方面存在明显差异(Fisher精确检验,P=0.028),其他方面无显著性差异。结论中老年(≥55岁)初发癫痫临床发作和脑电图均以颞叶为主。病因以脑血管病最多见,头颅影像学无明显特征性改变,中年和老年癫痫各方面表现基本无明显差异。

Objective To study clinical manifestations,features of EEG and brain imaging in patients of epilepsy older than 55 years old.Methods Clinical informations and VEEG records of participants were gathered. Analysis was made according to detailed information by SPSS 23.0.Results Partial seizures(74.3%) and temporal lobe epilepsy(TLE)(31.3%)were most frequently diagnosed.The most common etiological diagnosis was cerebrovascular disease.Interictal EEG showed epileptiform discharges(n=45,61.6%),prominent in temporal lobe.No significant difference except for hippocampal sclerosis(Fisher test,P=0.028)was found including clinical features,EEG characteristics and etiology when Compared late-onset(55~65 years old)epilepsy withsenile epilepsy.Conclusion Partial seizures were the most common manifestations in epileptic patients older than55 years old.Among them abnormal behaviors,focal movements and sensory abnormalities were most frequent.Abnormal waves were mainly detected in temporal lobe.Cerebrovascular disease was the most common etiological diagnosis.