Late onset epilepsy findings in a developmental country, a report of first results

Introduction: Older patients with Late onset epilepsy (LOE) provide a special set of difficulties for both the treating doctors and the patients.

Objectives: To address the characteristics and treatment outcomes of LOE in a cohort of Egyptian population at a tertiary center and to assess factors affecting seizure freedom in this age group.

Methods: From December 1, 1995, to November 30, 2020, we analysed all patients with newly diagnosed epilepsy above the age of 50 at Cairo University's neurology department. The term "seizure freedom" was used to refer to the absence of seizures or auras for at least 12 months. Patients were classified as either having achieved seizure freedom or not.

Results: One hundred and twenty-one patients were included. The median follow-up time was 24 months. 69.4 % attain seizure freedom. 52.1 % of our patients had symptomatic epilepsy. Among this group, 31.4 % (n = 38) had epilepsy caused by cerebrovascular disease (ischemic or hemorrhagic). Patients with epileptogenic lesions in neuroimaging, and those who are receiving ≥ 2 ASMs had significantly higher probability of not achieving seizure freedom for 12 months compared to those with normal or non-epileptogenic lesions in neuroimaging and receiving ≤ 1 ASMs with significant trends a trend toward lower seizure freedom in both.

Conclusion: Patients with Late- onset epilepsy have an excellent chance of achieving seizure freedom, especially those controlled on 1 ASM and those with normal neuroimaging.