Presumed aetiologies and clinical outcomes of non‐lesional late‐onset epilepsy

• DOI: 10.1111/ene.16432
• Publication Date: 2024-08-16T12:40:02Z
• Authors: Salomé Puisieux; Natacha Forthoffer; Louis Maillard; Lucie Hopes; Thérèse Jonveaux; Louise Tyvaert
• Keywords: Etiology; Cognitive Decline

Abstract Background and purpose Our objective was to define phenotypes of non‐lesional late‐onset epilepsy (NLLOE) depending on its presumed aetiology determine their seizure cognitive outcomes at 12 months. Methods In all, 146 newly diagnosed NLLOE patients, >50 years old, were prospectively included categorized by four aetiological subtypes: neurodegenerative subtype (patients with a diagnosis disease) ( n = 31), microvascular three or more cardiovascular risk factors two vascular lesions MRI) 39), inflammatory (patient meeting international criteria for encephalitis) 9) unlabelled (all individuals who did not meet the other subtypes) 67). Cognitive outcome determined comparing each patient proportion preserved/altered scores between initial second neuropsychological assessment. Results The had most severe profile complaint dating back several years. mainly evaluated through neurovascular emergency pathway. Their seizures characterized transient phasic disorders. Inflammatory patients youngest. They presented an acute onset high rate focal status epilepticus. fewer comorbidities brain imaging. worst outcomes. groups, control good under antiseizure medication (94.7% seizure‐free) performance stabilized even improved. Conclusion This new characterization raises questions regarding current International League Against Epilepsy classification which does individualize per se.