Epilepsy in the elderly

Abstract

Epilepsy is most likely to develop in later life. Making a secure diagnosis can be challenging because the clinical manifestations of seizures and the differential diagnoses and causes of epilepsy can be different in older individuals compared with younger individuals. In practice, common causes that should be specifically considered in patients with late-onset epilepsy include cerebrovascular disease, primary neurodegenerative disorders associated with cognitive impairment (particularly Alzheimer’s disease). The most common type of epilepsy in elderly people is focal seizures with impaired awareness, the characteristic seizure’s symptoms are Non-convulsive status epilepticus, transient epileptic amnesia and long postictal confusion period. Elderly people are more likely to have comorbidities, particularly cerebrovascular disease and dementia, which all require recognition, evaluation, and management. Additionally, age-associated physiological changes can affect the pharmacokinetics and pharmacodynamics of antiepileptic drugs.