2018 Volume 67 Issue 3 Pages 403-409
The patient was a 78-year-old man. He felt bothered by the brightness of the setting sun while driving his car in the late afternoon, and experienced sudden spasms of his right hand, panicked, and collided against a guardrail. Magnetic resonance imaging of the head with a fluid-attenuated inversion recovery sequence revealed scattered high-intensity areas, and head magnetic resonance angiography showed stenosis of the right middle cerebral artery. About one second after initiating photic stimulation at 3 Hz during an electroencephalography (EEG) test, small spikes and slow waves occurred with frontal lobe dominance. Immediately after initiating photic stimulation at 12 Hz, spasms of the face and upper body occurred, and the patient did not respond when his name was called. The spasms ended after approximately 10 s, and he responded to his name being called again. This patient was clinically diagnosed as having symptomatic epilepsy on the basis of a medical interview, imaging findings, and epileptic discharge on EEG. With the arrival of the superaging society, the prevalence of epilepsy, which has been perceived as a pediatric disease, is expected to increase in the elderly as well. As epilepsy is a disease that can be treated pharmacologically, medical technologists administering EEG examinations, long-term care facility staff who work in close contact with many elderly individuals, and community care managers should be aware of elderly epilepsy.
