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Your search keyword '"Toledo-Argany M"' showing total 9 results
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4. 20562. ESTADO EPILÉPTICO EN PACIENTES CON PARADA CARDÍACA REFRACTARIA ASISTIDA MEDIANTE REANIMACIÓN CARDIOPULMONAR EXTRACORPÓREA Y FACTORES ASOCIADOS

Author

Montalvo Olmedo, C., Abraira del Fresno, L., Quintana, M., Campos Fernández, D., Girame Rizzo, L., Vidal Burdeus, M., Riera del Brío, J., Argudo Serra, E., Sánchez Corral, A., Sueiras Gil, M., Thonon, V., López Maza, S., Fonseca Hernández, E., Toledo Argany, M., and Santamarina Pérez, E.

Published
2024
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9. [Risk of epilepsy after a first epileptic seizure with unknown etiology in elderly patients].

Author

López-Maza S, Abraira L, Bellido-Castillo E, Lallana S, Campos-Fernández D, Fonseca E, Quintana M, Santamarina E, Rovira A, Sarria-Estrada S, and Toledo-Argany M

Subjects
Humans, Male, Female, Retrospective Studies, Aged, Middle Aged, Magnetic Resonance Imaging, Risk Factors, Seizures etiology, Seizures complications, Aged, 80 and over, Risk Assessment, Epilepsy etiology, Epilepsy complications, Electroencephalography
Abstract

Aim: Patients whose epilepsy begins with seizures with unknown etiology in old age have been studied to a limited extent. The aim is to clinically characterise these patients, and predict their risk of developing epilepsy in the long term., Materials and Methods: This is a retrospective observational study of patients over 55 years old experiencing a first epileptic seizure with unknown etiology. The data were collected from their clinical history, including electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) results., Results: Eighty-seven patients (58.6% male; 71.5 ± 8.1 years) were included. The mean follow-up was 7.3 ± 4.9 years. The most common vascular risk factor was arterial hypertension (77%; n = 67). Focal seizures with altered consciousness were the most frequent type of seizure (44.8%; n = 39), followed by focal seizures evolving to bilateral tonic-clonic seizures (39.1%; n = 34). Brain MRI showed cortical atrophy (50%; n = 42) and signs of small-vessel vascular disease (SVVD) (67.8%; n = 57). Interictal epileptiform EEG abnormalities were observed in 43.7% (n = 38) of the patients, mostly with temporal localisations (94.7%; n = 36). 44.8% (n = 39) had mild cognitive impairment at baseline. Recurrence of seizures, which was observed in 49 patients (56.1%), occurred after a median of 12 months (interquartile range: 4.4-25.9). Finally, 71 patients (81.6%) developed epilepsy., Conclusion: The risk of epilepsy in the long term following a single seizure of unknown etiology in elderly patients is greater than 80%. Arterial hypertension and mild cognitive impairment at baseline are the most common clinical features. Cortical atrophy and the presence of SVVD are frequent in MRI, and routine EEGs do not usually show epileptiform alterations.

Published
2024
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