Idiopathic generalised epilepsy of late onset - A separate nosologic entity?
Résumé
PURPOSE: Seizure onset in idiopathic generalised epilepsies (IGE) is considered to be rare after the second decade of life. We aimed to explore age of seizure onset in a large population of patients with IGE and compare “classical” onset to late onset cases. METHODS: Patients with IGE, treated at the outpatient epilepsy clinic (Medical University of Innsbruck, Austria, 1985-2006, n=798) were retrospectively screened. Inclusion criteria were: Diagnosis of IGE, more than two follow up (FU) visits, duration of FU more than one year, normal brain imaging. We analysed demographic data, age of seizure onset, seizure types, syndromes, neuroimaging and EEG findings, seizure triggers, seizure freedom for one and five years at last FU. RESULTS: A total of 492 patients (mean age at seizure onset 14.6 years, range 0.1-55, SD 7.9) with IGE were identified: CAE (n=113, range 1-55, SD6.5), JAE (n=75, range 4-39, SD 5.1), JME (n=112, range 2-39, SD 5.7), and EGMA (n=192 range 1-52, SD 17.3). Population was stratified into three groups: 28 patients with seizure onset at >30yrs, 180 between 15 and 30 years and 284 <15years. Distribution of seizure types and epilepsy syndromes differed significantly in group comparison (p<0.001); seizure outcome and other clinical variables did not differ throughout the groups. CONCLUSION: Apart from age related onset of seizure types and syndromes with a loose upper limit of onset age patients with a late onset did not differ from their younger counterparts. Our data does not support the view of IGE of late onset as a separate syndrome.
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