ArticleEuropean journal of neurology2024
Presumed aetiologies and clinical outcomes of non-lesional late-onset epilepsy.
Article in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- EEG features in late-onset epilepsy: possible correlation with cognitive impairment.Brain communications · 2026Article
- BrainEpilepsia · 2025Article
- Glymphatic System Dysfunction in Elderly Patients with Late-Onset Epilepsy and Comorbid Chronic Insomnia Revealed by Diffusion Tensor Imaging Along the Perivascular Space (DTI-ALPS).Neuropsychiatric disease and treatment · 2025Article
- Presumed aetiologies and clinical outcomes of non-lesional late-onset epilepsy.European journal of neurology · 2024Article
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6 authors.
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Abstract
background and purposeOur objective was to define phenotypes of non-lesional late-onset epilepsy (NLLOE) depending on its presumed aetiology and to determine their seizure and cognitive outcomes at 12 months.
methodsIn all, 146 newly diagnosed NLLOE patients, >50 years old, were prospectively included and categorized by four presumed aetiological subtypes: neurodegenerative subtype (patients with a diagnosis of neurodegenerative disease) (n = 31), microvascular subtype (patients with three or more cardiovascular risk factors and two or more vascular lesions on MRI) (n = 39), inflammatory subtype (patient meeting international criteria for encephalitis) (n = 9) and unlabelled subtype (all individuals who did not meet the criteria for other subtypes) (n = 67). Cognitive outcome was determined by comparing for each patient the proportion of preserved/altered scores between initial and second neuropsychological assessment.
resultsThe neurodegenerative subtype had the most severe cognitive profile at diagnosis with cognitive complaint dating back several years. The microvascular subtype was mainly evaluated through the neurovascular emergency pathway. Their seizures were characterized by transient phasic disorders. Inflammatory subtype patients were the youngest. They presented an acute epilepsy onset with high rate of focal status epilepticus. The unlabelled subtype presented fewer comorbidities with fewer lesions on brain imaging. The neurodegenerative subtype had the worst seizure and cognitive outcomes. In other groups, seizure control was good under antiseizure medication (94.7% seizure-free) and cognitive performance was stabilized or even improved.
conclusionThis new characterization of NLLOE phenotypes raises questions regarding the current International League Against Epilepsy aetiological classification which does not individualize neurodegenerative and microvascular aetiology per se.
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