EPILEPTIC SEIZURES IN THE ELDERLY: II. DIAGNOSTIC PROBLEMS

Three principal diagnostic problems were encountered in a group of 81 elderly patients with epileptic seizures: Post-ictal paresis (Todd's palsy) occurred in 13 patients (16%), of whom seven had evidence of past or present cerebral infarction, and six no such evidence. The paresis lasted up to...

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Bibliographic Details
Published in:Age and ageing 1982, Vol.11 (1), p.29-34
Main Authors: GODFREY, J. W., ROBERTS, MARGARET A., CAIRD, F. I.
Format: Article
Language:English
Subjects:
Aged
Brain - blood supply
Cerebral Infarction - diagnosis
Confusion - complications
Confusion - diagnosis
Dementia - complications
Diagnosis, Differential
Electroencephalography
Epilepsy - drug therapy
Epilepsy, Tonic-Clonic - complications
Epilepsy, Tonic-Clonic - diagnosis
Epilepsy, Tonic-Clonic - drug therapy
Female
Humans
Male
Pain - complications
Paresis - complications
Paresis - diagnosis
Phenytoin - therapeutic use
Shoulder
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Summary:Three principal diagnostic problems were encountered in a group of 81 elderly patients with epileptic seizures: Post-ictal paresis (Todd's palsy) occurred in 13 patients (16%), of whom seven had evidence of past or present cerebral infarction, and six no such evidence. The paresis lasted up to 4 days, and could be confused with recurrent cerebral infarction or a transient ischaemic episode. Ictal and post-ictal confusional states of 24 h or more duration (up to 7–8 days) were noted in 11 patients (14%). They occurred in association with normal intellectual function as well as with pre-existing dementia, and required to be distinguished from other causes of delirium. Two patients presented paroxysmal sensory phenomena of ictal type. The differential diagnosis of episodic pain in hemiplegic limbs is discussed.
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/11.1.29