Aetiological Features of ≥50 Years Old Patients with Newly Diagnosed Epilepsy in Eastern China

Purpose: The incidences of epilepsy in people aged 50 and above were at least twice than those in young people. Identifying the under cause is of great importance.In the present study, we summarized the aetiologic features aged ≥50 years old patients with newly diagnosed epilepsy in eastern China. Methods : We prospectively enrolled people older than 50 years with newly diagnosed epilepsy who were admitted in our hospital between January 2023 to October 2025. Demographic data, clinical characteristics,ASMs treatment, epilepsy-associated risk factors and medical history, and results of supplementary examinations of each participant were collected retrospectively via an interviewer-administered questionnaire and confirmed by the medical records. Results :Among 201 people enrolled , 64.18% of them were male. Aged 60 and above were more common, followed by those aged between 50 and 60, between 70 and 80 being the least. Cerebrovascular disease was the leading putative cause (40.80%) ,followed by unknown causes(20.90%).13 had remote traumatic brain injury(6.47%) ,which was the lowest proportion. Primary intracranial brain tumors and central nervous system(CNS) infections accounted for the same proportion. Among cerebrovascular disease, ischemic stroke was the leading cause,especially aged 60 and above. But in patients aged 50 to 60, ischemic stroke and intracranial vascular malformations (IVMs) were all the leading causes, arteriovenous malformations (AVMs) were the most common in IVMs.However, in female patients, IVMs appeared to account for a higher proportion of causes among those aged 50 to 60. Significance :In ≥50 years old patients with newly diagnosed epilepsy,stroke,especially ischemic stroke was the leading putative cause,especially aged 60 and above. But for young women, epilepsy caused by cerebrovascular malformations couldnot be ignored.