高齢（50歳以上）てんかん患者の臨床的検討—若年発症例の後方視的研究

Clinical Research of Patients with Epilepsy Over Age 50 years : A Retrospective Study of Early Onset Case

　高齢てんかん患者の臨床特性を明らかにするために，50歳以前にてんかん発作を発症し，調査時点で50歳以上のてんかん患者116例について検討を行った。調査時点から遡って3年以内に発作を生じた発作残存群は84例，3年以上発作出現のない発作消失群は32例であった。

　てんかん類型は両群ともに部分てんかんが7割以上を占め，全般てんかんは少数であった。発作残存群において，進行性ミオクローヌスてんかんを11例認めた。

　発作類型をみると，単一の発作型では全般けいれん発作（GCS）が消失群に多く認められた。また複数の発作型をもつ残存群においても，GCSの多くは抑制されていた。

　既往に治療対象となる何らかの精神症状をもつものが両群ともに3割を占めた。なかでも幻覚妄想状態は残存群12例，消失群5例に認められた。発作残存群において，高率に知能障害を認めた。

One hundred-sixteen patients with epilepsy over 50 years old were investigated to explore the clini-cal charactaristics of epilepsy in elderly persons. Eighty-four patients having seizures within the last 3 years (residual group) were compared with 32 patients having no seizures within the last 3 years (disappeared group).

Regarding the epilepsy type, there were 87 partial epilepsies (64 in the residual group and 23 in the disappeared group) which were approximately 70 percents of the total patients. Generalized epilepsies were comparatively rare in the both groups. Eleven patients with progressive myoclonus epilepsy were obsereved in the residual group.

Regarding the seizure type, generalized convul-sive seizures (GCS) were more likely to disappear than partial seizures regardless of number of sei-zures the patient had.

Thirty-eight patients (29 in the residual group and 9 in the disappeared group) had histories of psychiatric problems. Paranoid states were most commonly seen in 12 patients in the residual group and 5 patients in the disappeared group. Intellectual disturbance was seen more frequently in the resi-dual group.