Idiopathic generalized epilepsy of late onset

Most idiopathic generalized epilepsies have an onset in childhood or adoles cence, with a moderate second incidence peak in the presenium predominantly in women. This study addressed the question of a later onset. The availabl e Literature and the records of four personal data sets (two prospective in cidence surveys of epileptic seizures, one prevalence study of epilepsy, an d one clinical series of individuals with epilepsy) were screened for patie nts who had experienced a first generalized convulsive seizure with bilater al spike-wave complexes on EEG after 60 years of age. Reports of first idio pathic generalized tonic-clonic seizures occurring after age 60 were extrem ely rare and none was found in our four cohorts regardless of the methodolo gy involved. Only five case reports were found, all involving a woman. Two had a family history of seizure disorders and two had had at least one seiz ure earlier in life. Idiopathic generalized epilepsy of late onset, if this condition actually exists, is likely to be the consequence of a genetic pr edisposition triggered by acquired epileptogenic factors.