In the northern part of Hokkaido, our hospital belongs to the semi-training facility for the Japanese epilepsy society conducted by a certificated epileptologist with the neurological board. We retrospectively investigated the clinical features and treatments of new-onset geriatric epilepsy over 65 years old in our hospital from April 2011 to March 2018. We divided the periods at the March 2015 when we were able to use the new generation antiepileptic drugs. Forty four patients, the former 16 and the latter 28, were included, their average onset age was 77.0 years old. The chief complaints were generalized convulsion (45.4%), consciousness disturbance (27.3%), and forgetfulness (22.3%). All the patients were focal epilepsy, including temporal lobe epilepsy (36.4%). The main underlying diseases consisted of the stroke (38.6%) and dementia (25.0%), and both exist more in the latter period. Seizure freedom ratio was 81.4%, 60% in the former period and 85% in the latter period by single antiepileptic drug. Stroke and dementia were seen in the new onset geriatric epilepsy much more in the latter period in our hospital, and seizure freedom ratio by single antiepileptic drug was also higher in this period. It suggests that we can control the epileptic seizures even caused by stroke and dementia with new generation antiepileptic drugs.

We investigated the real data regarding vehicle collisions due to an epileptic attack and the criminal liability of drivers after the implementation of the "Act on Punishment of Acts Inflicting Death or Injury on Others by Driving a Motor Vehicle, etc.". Moreover, circumstances of the cases before and after the new law implementation were compared.

The enforcement of the new law was meant to toughen the law for an appropriate effect. Nearly 90% of 26 cases were indicted for "Dangerous Driving Causing Death or Injury". Out of theses cases, 19 drivers were found guilty, three were not proven guilty, and four were exempted from prosecution. Although the number of epileptic drivers supervised by a doctor is significantly increasing, some drivers disrespected this evaluation or discontinued the prescribed drugs. Hence, drivers with epilepsy require careful attention and supervision by a doctor. Furthermore, it would be critical to facilitate epilepsy diagnosis in the elderly because of the high rate of onset of epilepsy.