Video-electroencephalography Characteristics of Old Patients with Epilepsy_West China Medical Journal

Authors：

 LINYan ^1,2 , 安東梅 ¹ ,  ANDong-mei ¹

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, East Ward, Sichuan Provincial Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding?author：

ANDong-mei, Email: zjllxx1968@163.com

Keywords：

Video electroencephalogram; Electroencephalography; Old patients with epilepsy

DOI：

10.7507/1002-0179.20150179

Video：

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Objective To investigate the video-electroencephalography (VEEG) characteristics of old patients with epilepsy (OPWE). Methods Between June 2013 and July 2014, 57 OPWE at an age over 60 years were assigned to research group and 65 adults between 16 and 60 years old with epilepsy were regarded as controls. All the subjects underwent VEEG for 24 hours covering awake state and sleep with hyperventilation test being applied. Chi square was used to compare occurrence rate of epileptic wave and abnormal response rate after hyperventilation between the two groups of patients. Additionally, ictal elcetroencephalograph (EEG) was analyzed. Results Common features of waves on EEG for patients in both the two groups during the ictal period included widespread low amplitude fast wave (2 cases in the research group, 7.4%; 4 cases in the control group, 12.5%), focal low amplitude fast wave (5 cases in the research group, 18.5%; 6 cases in the control group, 18.8%), widespread spike or spike slowing complex (3 cases in the research group, 11.1%; 7 case in the control group, 21.8%), focal spike or spike slowing complex (5 cases in the research group, 14.9%; 8 cases in the control group, 25.0%), and focal rhythmic slow wave (6 cases in the research group, 18.5%; 6 cases in the control group, 18.8%). In the research group, there were two following cases:single abnormal background activity in 5 cases (18.5%), and neither abnormal background activity nor epileptic discharge in 1 case (3.7%). Ictal focal epileptic discharges were found in 16 cases in the research group and 8 in the control group (59.3% vs 25.0%), with statistical difference (P<0.05). Inter-ictal epilepsy discharges were found in 57 patients of the research group (awake, 15.8%; sleep, 52.6%), which was less than that in the control group (awake, 46.2%; sleep, 83.1%) with statistical difference (P<0.05), accompanied by focal slow wave (temporal intermittent rhythmic delta activity, TIRDA) in 9 cases. In natural sleep period, epilepsy discharge occurrences increased (65.3%). Abnormal response rate in the research group (14.0%) was lower than that in the control group (64.6%) with statistical difference (P<0.05). Conclusion Early onset EEG of the old and the adult are similar except those with single abnormal background activity and those with neither abnormal background activity nor epileptic discharge. Focal onset on EEG is more frequently seen in OPWE than in APWE. In natural sleep, epileptic discharge increases among OPWE, and abnormal response during hyperventilation is less likely to happen in OPWE.

Citation： LINYan, ANDong-mei. Video-electroencephalography Characteristics of Old Patients with Epilepsy. West China Medical Journal, 2015, 30(4): 613-617. doi: 10.7507/1002-0179.20150179 Copy

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12.	姬文珍, 張雪青. 老年癲癇患者的臨床特點及誤診原因分析[J]. 山東醫藥, 2014, 54(6):80-81.
13.	Jungehulsing GJ, Heuschmann PU, Holtkamp M, et al. Incidence and predictors of post-stroke epilepsy[J]. Acta Neurol Scand, 2013, 127(6):427-430.
14.	王湘慶. 老年癲癇患者的診斷及治療[J]. 中華老年心腦血管病雜志, 2013, 5(5):559-560.
15.	Faulkner HJ, Arima H, Mohamed A. The utility of prolonged outpatient ambulatory EEG[J]. Seizure, 2012, 21(7):491-495.
16.	苗茂華, 曲成毅, 任艷峰, 等. 社區老年人腦電圖特征及其與認知功能關系的研究[J]. 中國老年學雜志, 2008, 28(12):1085-1087.
17.	Gaspard N, Manganas L, Rampal N, et al. Similarity of lateralized rhythmic delta activity to periodic lateralized epileptiform discharges in critically ill patients[J]. JAMA Neurol, 2013, 70(10):1288-1295.
18.	Ebersole JS, Pedley TA. 現代臨床腦電圖學[M]. 3版. 北京:人民衛生出版社, 2009:223.
19.	Yu-Dan L, Zan W, Ma DH, et al. Association between epileptiform discharges and the sleep cycle in 200 epileptic patients[J]. Int J Neurosci, 2013, 123(3):196-203.
20.	呂高萍, 蘇涵, 蔣麗麗. 24 h動態腦電圖在老年癲癇診斷中的應用[J]. 吉林醫學, 2012, 33(33):7207.

1. Nakano H, Inoue Y. Epidemiology and cause of epilepsy[J]. Nihon Rinsho, 2014, 72(5):785-789.
2. Verellen RM, Cavazos JE. Pathophysiological considerations of seizures, epilepsy, and status epilepticus in the elderly[J]. Aging Dis, 2011, 2(4):278-285.
3. 黃永鋒. 老年性癲癇的病因及腦電圖特點[J]. 中國老年學雜志, 2013, 33(2):401-402.
4. Kinoshita M, Ikeda A. Paroxysmal symptoms in the elderly; epileptic seizures or not[J]. Nihon Rinsho, 2013, 71(10):1858-1863.
5. 張建, 華琦. 中國老齡化的特征發展趨勢與對策[J]. 中國心血管雜志, 2010, 15(1):79-80.
6. Fisher RS, Boas WV, Blume W, et al. Epileptic seizures and epilepsy:definitions proposed by the International League against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)[J]. Epilepsia, 2005, 46(4):470-472.
7. Kane N, Grocott L, Kandler R, et al. Hyperventilation during electroencephalography:safety and efficacy[J]. Seizure, 2014, 23(2):129-134.
8. Si Y, Liu L, Hu J, et al. Etiologic features of newly diagnosed epilepsy:hospital-based study of 892 consecutive patients in West China[J]. Seizure, 2012, 21(1):40-44.
9. Blum AS. Epilepsy concerns in older patients[J]. Med Health R I, 2012, 95(3):79-80.
10. Davidson Petra N, Davidson Keith A. Electroencephalography in the elderly[J]. Neurodiagnostic Journal, 2012, 52(1):3.
11. Verellen RM, Cavazos JE. Pathophysiological considerations of seizures, epilepsy, and status epilepticas in the elderly[J]. Aging Dis, 2011, 2(4):278-285.
12. 姬文珍, 張雪青. 老年癲癇患者的臨床特點及誤診原因分析[J]. 山東醫藥, 2014, 54(6):80-81.
13. Jungehulsing GJ, Heuschmann PU, Holtkamp M, et al. Incidence and predictors of post-stroke epilepsy[J]. Acta Neurol Scand, 2013, 127(6):427-430.
14. 王湘慶. 老年癲癇患者的診斷及治療[J]. 中華老年心腦血管病雜志, 2013, 5(5):559-560.
15. Faulkner HJ, Arima H, Mohamed A. The utility of prolonged outpatient ambulatory EEG[J]. Seizure, 2012, 21(7):491-495.
16. 苗茂華, 曲成毅, 任艷峰, 等. 社區老年人腦電圖特征及其與認知功能關系的研究[J]. 中國老年學雜志, 2008, 28(12):1085-1087.
17. Gaspard N, Manganas L, Rampal N, et al. Similarity of lateralized rhythmic delta activity to periodic lateralized epileptiform discharges in critically ill patients[J]. JAMA Neurol, 2013, 70(10):1288-1295.
18. Ebersole JS, Pedley TA. 現代臨床腦電圖學[M]. 3版. 北京:人民衛生出版社, 2009:223.
19. Yu-Dan L, Zan W, Ma DH, et al. Association between epileptiform discharges and the sleep cycle in 200 epileptic patients[J]. Int J Neurosci, 2013, 123(3):196-203.
20. 呂高萍, 蘇涵, 蔣麗麗. 24 h動態腦電圖在老年癲癇診斷中的應用[J]. 吉林醫學, 2012, 33(33):7207.

West China Medical Journal

Video-electroencephalography Characteristics of Old Patients with Epilepsy

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