Medline ® Abstracts for References 3,4

As the elderly represent the most rapidly growing population in the United States, it is critical that physicians are capable of managing their chronic illnesses, including epilepsy. Optimal treatment of epilepsy integrates an understanding of health-related quality of life (HRQOL), yet limited information is available to guide HRQOL issues among the elderly. This study found that seniors with epilepsy do not have poorer HRQOL compared with general epilepsy populations. However, when compared with general populations without epilepsy, seniors with epilepsy report a significantly lower HRQOL across all domains. Multiple factors may uniquely affect HRQOL among elderly populations with epilepsy: aging, comorbid conditions, and epilepsy variables. However, to our knowledge, no one instrument addresses all of these aspects. The development of HRQOL instruments specifically for an elderly population with epilepsy may be useful and needed.

OBJECTIVE: The goal of this study was to assess the characteristics and risk factors for injuries caused by seizures in older persons.

METHODS: All patients aged 65 years or older having injuries secondary to seizures between July 1, 1999, and June 30, 2009, were identified through the diagnostic coding system.

RESULTS: Over the assessment period, a total of 615 patient episodes of seizures were recorded. Nineteen seizure-related injury events occurred in 18 persons with a total of 31 injuries. In the control group, 34 non-seizure-related injuries that were not seizure related occurred in 27 patients (28 patient episodes) (P = 0.21). The majority of injuries in both groups resulted from falls. Fifty-three percent of seizures occurred indoors, and the majority of seizures were generalized tonic-clonic seizures. Of the seizure-related injury events, 8 (42%) were single injuries, and 11 (61%) were multiple injuries. The predominant injuries were soft tissue injuries (55%), fractures (35%), and head injuries (10%). The groups did not differ significantly with respect to fractures (P = 0.06) or soft tissue injuries with lacerations (P = 0.41), or injury severity (P = 0.16),or treatment of osteoporosis (P = 0.56).

CONCLUSION: These findings suggest that falls rather than seizures per se are the dominant influence in the pathogenesis of fractures in older patients with epilepsy.