Objectives. The aim of the present study was to investigate the causes of prolonged (lasting over 12 hrs) disturbances of consciousness in patients aged 60 and above, and to develop optimal diagnostic and therapeutic procedures to be used in such cases.
Method. Analyzed were data obtained from patients with prolonged (over 12 hours) disturbances of consciousness, hospitalized in the 1st Neurological Department of the Institute of Psychiatry and Neurology between 01.11.2003 and 30.10.2005. The case series included 130 patients, mean age 75.7±8.8 years, 82 (63.1%) women and 48 men.
Results. In 28 patients prolonged disturbances of consciousness were due to a haemorrhagic stroke, mostly (in 90% of the cases) penetrating into the ventricular system, while in 27 patients previously diagnosed with epilepsy of non-vascular origin they were usually preceded by a convulsive seizure. The most numerous group in our study were 40patients with cerebrovascular lesions. In this group 7 cases (17.5%) had been diagnosed earlier with post-stroke epilepsy. In the remaining patients disturbances of consciousness were caused by infectious diseases, cerebral tumours, acute ischemic stroke, and blood flow insufficiency in posterior regions of the brain.
Conclusions. In the cases of prolonged disturbances of consciousness in persons aged over 60, a possibility of epilepsy should be taken into account in the differential diagnosis, especially in patients with a history of brain damage of vascular origin.