論文

査読有り 国際誌
2018年10月

Status epilepticus in the elderly: Comparison with younger adults in a comprehensive community hospital.

Seizure
  • Hajime Yoshimura
  • ,
  • Riki Matsumoto
  • ,
  • Hiroyuki Ueda
  • ,
  • Koichi Ariyoshi
  • ,
  • Akio Ikeda
  • ,
  • Ryosuke Takahashi
  • ,
  • Nobuo Kohara

61
開始ページ
23
終了ページ
29
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.seizure.2018.07.013

PURPOSE: Previous studies on status epilepticus (SE) in the elderly were conducted in tertiary centers. We aimed to delineate the features and outcomes of elderly SE patients by comparing them to those of younger patients in a comprehensive community hospital providing primary to tertiary care. METHODS: We retrospectively investigated 197 consecutive adult SE patients admitted to our hospital. The clinical, electroencephalography, and diffusion-weighted imaging (DWI) findings of 112 elderly patients (aged ≥65 years) were compared to those of 85 younger patients (aged <65 years). RESULTS: Compared to that in younger patients, SE in elderly patients more frequently presented de novo (68.8% vs. 52.9%, p = 0.02); was less likely to be tonic-clonic (55.4% vs. 83.5%, p < 0.001) but more likely to be focal motor (36.6% vs. 12.9%, p < 0.001); and was more frequently refractory (30.4% vs. 14.1%, p = 0.008), particularly refractory nonconvulsive SE (13.4% vs. 4.7%, p = 0.04). Lateralized periodic discharges on electroencephalography (20.9% vs. 4.8%, p = 0.001) and SE-associated hyperintensities on DWI (27.8% vs. 13.6%, p = 0.03) were more common in the elderly than in the younger SE patients. The mortality rates did not significantly differ between the groups (6.3% vs. 3.5%, p = 0.52). The percentage of poor functional outcomes did not significantly differ between the groups in cases with acute symptomatic etiology (52.0% vs. 45.7%, p = 0.63), but was higher in elderly patients with remote symptomatic and cryptogenic etiologies (33.3% vs. 12.0%, p = 0.006). CONCLUSIONS: SE in the elderly differed from that in younger adults in the semiology, refractoriness, electroencephalography and DWI findings, and functional outcome. Outcomes were better than previously reported.

リンク情報
DOI
https://doi.org/10.1016/j.seizure.2018.07.013
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30056319
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85050387201&origin=inward 本文へのリンクあり
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85050387201&origin=inward
ID情報
  • DOI : 10.1016/j.seizure.2018.07.013
  • ISSN : 1059-1311
  • eISSN : 1532-2688
  • PubMed ID : 30056319
  • SCOPUS ID : 85050387201

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