Crise d’épilepsie de novo chez le sujet âgé de plus de 65ans au CHU Félix Guyon de la Réunion

Abstract : Introduction: epilepsy is a more frequent affection in the elderly than in younger adult. The incidence of newly diagnosed epilepsy is high in Reunion island and can be explained by epidemiological feature. The main objective of this work was to describe the characteristics of epileptic seizures occurring in two populations of elderly patients (65-79 years and over 80 years). Methods: we conducted a retrospective study from January 1, 2014 to December 31, 2015. All patients over 65 years, hospitalized at CHU Félix Guyon, with a first epileptic seizure were included. Results: we included 117 patients (69 women and 48 men, mean age 79.7 years), 43 of whom were over 80 years. The reasons for hospitalization were varied. The diagnosis of epilepsy (status epilepticus included) was already found for 39.32% of the patients. 18.80% of the patients included were hospitalized for confusion. The seizures were partial in 56.41% of the cases and generalized tonic-clonic in 35.90%. Thirty-seven patients had status epilepticus. 36.75% of patients experienced acute symptomatic seizure versus 63.25% for unprovoked seizures. For 9 patients, there were 2 etiologic diagnoses. Cerebrovascular disease were the most common etiology with 42.74% of cases, followed by unknown etiology (24.79%), head injury (12.82%) cerebral tumors (7.69%), metabolic disease (5, 98%) and dementia (3.42%). There was no significant difference between the two groups of patients. Conclusion: epilepsy in the elderly is a difficult diagnosis due to a large polymorphism of seizures with often multifactorial causes. General practitioners must be aware of this condition, especially in Reunion island where the elderly are in poorer health than their metropolitan counterparts.
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Cécile Teste. Crise d’épilepsie de novo chez le sujet âgé de plus de 65ans au CHU Félix Guyon de la Réunion. Médecine humaine et pathologie. 2017. ⟨dumas-01588396⟩

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