Characterizing Generalized Epilepsy in Elders: Vineet Punia, MD, MS


The neurologist at Cleveland Clinic discussed how his data may change clinicians’ perception on the management and prevalence of generalized epilepsy in elders.

"When we talk about generalized epilepsy, the typical picture that comes to mind is of young children, adolescents, and young adults. That’s when, in general, generalized epilepsy onset starts. Around 90% to 95% of patients who have generalized epilepsy are younger patients. It’s quite rare to have older patients with generalized epilepsy, especially new onset generalized epilepsy.”

An analysis presented at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, described the clinical features and management of elderly individuals with generalized epilepsy who underwent epilepsy monitoring unit evaluation. In an effort to fill this knowledge gap, researchers performed a single-center cohort study that included data on age of seizure onset, anti-seizure medication use, and seizure types.

The median age of epilepsy onset among 30 individuals was 16 (interquartile range, 6-56) years, while one-third (n = 10) of patients had late-onset generalized epilepsy. Generalized tonic-clonic seizures were experienced by 19 of 20 (95%) compared to 6 (60%) late onset patients (P = .03). Vineet Punia, MD, MS, neurologist, Cleveland Clinic, was among the researchers involved with the work and claimed that it was shocking to see the number of patients diagnosed with onset of generalized epilepsy after the age of 50 years.

In an interview with NeurologyLive, Punia sat down to describe his study in full detail, as well as the history between focal and generalized epilepsy and their prevalence in different age groups. He also stressed that his data should serve as a reminder to clinicians that not all late-onset epilepsies are focal.

Alzahary M, Punia V. Generalized epilepsy in the elderly undergoing epilepsy monitoring unit evaluation. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22. Abstract P7.080
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