シンポジウム14：神経救急における脳神経内科医の役割
高齢者てんかん診療における脳神経内科医の役割
2022 年 39 巻 4 号 p. 546-549
詳細
2022 年 39 巻 4 号 p. 546-549
Epilepsy is a common disease in the elderly. About 1.5% of elderly individuals are thought to suffer from epilepsy ; however, the medical system is insufficient to handle this burden, due to the small number of neurologists who specialize in epilepsy. The symptoms of seizures in the elderly tend to be different from those in younger patients. Moreover, accurate diagnosis of seizure in the elderly is not easy, as such patients have more comorbidities and are at higher risk of other disease.
As a major cause of epilepsy in the elderly, management of post–stroke epilepsy (PSE) is important in stroke survivors. Developing PSE is associated with worse clinical outcomes and adversely affects patient quality of life. Good prediction models, such as CAVE or SeLECT score, have recently been developed to identify patients at high risk of late seizure. The use of these scores may help to develop more personalized therapies.
High efficacy and safety are indispensable for antiseizure medications for epilepsy in the elderly. Further, clinicians should consider drug–drug interactions, especially when using older generation antiseizure medications.
