Etiology and electroclinical pattern of late onset epilepsy in Ibadan, Southwestern Nigeria
Late onset epilepsy (LOE) is a common neurological problem throughout the world. It is an area that has not been fully explored in the developing countries like Nigeria. The aim of the present study is to determine the pattern of presentation of late onset epilepsy with the view to identifying the etiologic as well as describe their electro-clinical pattern.
120 consecutive patients presenting at the University College Hospital with LOE were recruited. A detailed history was obtained in every case, and complete neurological examination was performed. EEGs were done in all patients. Contrast CT Scans and MRI were performed.
One hundred and twenty subjects comprising 71 (59.2%) males and 49 (40.8%) females were studied. The ages of the patients ranged between 25 and 85 years with a mean of 53years (sd =14.6). The ages at onset of epilepsy ranged between 25 and 84 years with a mean of 52 (sd=14.8). All the subjects had classifiable seizure types, 31 (25.8%) had generalized seizure. The most common type of seizure was partial seizure diagnosed in 89 (74.2%) subjects. Fifty two (43.3%) of the subjects had abnormal neurological findings. Twenty one (30.9%) had cerebral infarcts and 20 (29.4%) had cerebral tumor. Those with symptomatic epilepsy were more likely to have neurologic deficit, simple partial seizure, secondarily generalized seizure, focal epileptiform discharges and focal slow waves.
The most common abnormalities in LOE were cerebral infarct and brain tumor. A careful history, neurological examination and an EEG are adequate in the initial work-up of patients with LOE.