Treatment strategies of status epilepticus in the elderly: a report from a single center in Japan

Abstract

Purpose: To investigate treatment strategies for status epilepticus (SE) in elderly patients.

Methods: The medical records of all patients aged ≥ 60 years who were admitted to Aizawa Hospital in Matsumoto because of ‘epilepsy’ or ‘seizure’ between April 2012 and January 2015 were retrospectively reviewed. We found 54 patients, and 11 of them had status epilepticus. We investigated their age, sex, causes, seizure types, responses to medication and outcome.

Results: The ages of the patients with SE were significantly higher than the ages of those with-out SE (p = 0.02). The cause of seizures was cerebrovascular diseases in 50% of the patients. Six patients with SE were administered diazepam suppository (4-8 mg) three to four times daily com-bined with intravascular phenytoin. No patient needed a ventilator during the period of SE or died from SE. The number of SE patients who did not recover the ability of oral intake after recovery from SE was significantly higher in those with secondary generalized seizures (p = 0.04) than in those with complex partial seizures. The patients who did not recover the ability of oral intake had significantly longer SE compared to those who recovered oral intake (p = 0.005).

Conclusion: A treatment strategy that is potent enough to abort seizures and at the same time has less serious adverse effects is desirable for elderly patients with SE.