Adult onset idiopathic generalized epilepsy: A hospital-based study

Objective: To find the occurrence of adult onset idiopathic generalized epilepsy (AOIGE) in patients attending the neurology outpatient department of a tertiary care centre.Methodology: A prospective observational study was conducted in the Neurology outpatient department of Civil Hospital, Karachi between January 2004 and December 2008. All patients with new onset generalized epilepsy at age 25 years and with no evidence of an epileptogenic focus on history, clinical examination, electrophysiology, radiology or laboratory investigations were included. A structured pro forma evaluating detailed history, neurological other systemic examination, electrophysiological, radiological and laboratory investigations were used to rule out focal epilepsy. Results were analyzed using SPSS 15.Results: A total of 426 patients were enrolled. On evaluation, majority (85.6 %) were diagnosed as cases of symptomatic epilepsy with various etiologies like stroke, intracranial mass lesion, post infectious or post traumatic states and other rarer causes. In the remaining 61 patients (14.3%) there was no evidence of an epileptogenic focus on seizure history, clinical examination or investigations and were labeled as cases of AOIGE. Most patients (60.6%) were males and mean age of onset of seizures was 35.7 years. Three seizure types; generalized tonic clonic, myoclonic and absences were identified.Conclusion: It was concluded that although adult onset idiopathic generalized epilepsy is not a common occurrence, but it does exist. However, adult onset epilepsies must be thoroughly investigated to rule out symptomatic epilepsy which is commoner than idiopathic epilepsy in this age group