A Study on Acute Symptomatic Seizures in the Elderly.

Acute symptomatic seizures are those caused or provoked by an acute medical or neurological insult and it is as common as epilepsy in the medical wards. Acute symptomatic seizures differ from epilepsy in several important aspects. First, unlike epilepsy, these seizures have a clearly identifiable proximate cause, to the extent that one can never be certain of a causal association. When one considers the temporal sequence of acute symptomatic seizures (e.g.uremia, head injury, or stroke immediately preceding a seizure), the biologic plausibility (acute disruption of brain integrity or metabolic homeostasis) and in many cases the dose effect (severity of injury correlated with the risk for seizures) all quite compellingly indicate causation. Although a risk ratio for the immediate association between cause and effect has not been calculated, it must be enormous. Second, unlike epilepsy, acute symptomatic seizures are not characterized by a tendency to recur. The risk for subsequent epilepsy may be increased in individuals experiencing such insults; in general, one does not expect seizures to recur unless the underlying condition recurs. The maximum incidence of seizures occurred in the age group of 60 to 70 years in the study. Cerebrovascular disease was the most common etiology observed in our study. Among cerebrovascular disease, ischemic cerebral infarction was the most common cause. Central nervous system infections, was the second most common cause followed by metabolic causes in our study. So all efforts should be taken to evaluate the patients who presented with seizures in the elderly patients to identify the etiology, for accurate management. Partial seizures was the most common seizure type encountered in the study. Immediate non contrast CT brain was useful, for emergency patients, presenting with seizures to guide appropriate acute management. MRI Brain was useful in detecting lesions, which were missed in CT Brain. Both CT Brain and MRI Brain were indispensable in patients with acute symptomatic seizures in the elderly