Epidemiological and evolutionary aspects of epilepsy in the elderly in Sub-Saharan Africa case of Senegal

Introduction: Epilepsy in the elderly is the existence of at least 2 unprovoked epileptic seizures occurring within at least 24 hours in people over 65 years of age. It is 5 times more common in people over 75 years old than in young adults (24 to 35 years old) and represents the third neurological disease in the elderly after Alzheimer's disease and stroke. So, epilepsy is common in the elderly. It has epidemiological, electro clinical and etiological peculiarities compared to the forms of the child. Few studies have been carried out on the subject; hence we are conducting this study whose objective is to determine the prevalence of epilepsy of the subject and to give its evolutionary aspects under treatment. Patients and methods: We conducted a retro and prospective descriptive study in a 12-month period from December 1, 2019 to November 30, 2020. This study concerned patients aged 60 and over hospitalized for epileptic seizures or having presented a seizure during hospitalization. Results: Thirty nine epileptic patients aged 60 years and older were collected across 674 inpatients during the study period. The hospital prevalence was around 5.78%. Focal crises dominated the picture but it is important to emphasize the high frequency of generalized crises. The status epilepticus was common. The majority of patients responded better to the monotherapy prescribed, which was often carbamazepine and Phenobarbital. Mortality was around 20% and was not statistically related to the status epilepticus. Conclusion: Epilepsy is common in the elderly. Its hospital prevalence was about 5.78% of all hospitalized patients. Especially ischemic stroke was the most common cause whose manifestations were dominated by focal tonic-clonic attacks. The clinical evolution under anti epileptic treatment represented by carbamazepine and Phenobarbital was favorable in more than 79% of cases with a mortality not necessarily related to epilepsy of the order of 20.51%.