Epilepsy in the Elderly - Abstract
Both incidence and prevalence of epilepsy are high among the elderly patients. Epilepsy in the elderly differs in etiology, clinic features and prognosis. The most common etiological factor of epilepsy in the elderly is cerebrovascular diseases. Although most of the seizures in elderly patients are of focal onset, with or without secondary generalization, the presentation of seizures may be nonspecific. The diagnosis of epilepsy in the elderly patients may be difficult because of subtle semiological findings, co-morbid diseases, medications and age-related cognitive difficulties. A detailed history, a comprehensive neurological examination, routine laboratory tests, EEG and neuroimaging modalities are the cornerstones of diagnostic evaluation. Treatment of epilepsy in the elderly requires an understanding of the etiologies, medical and psychological aspects of this age group and should be based on careful assessment of risk/benefit profiles of antiepileptic drugs. The choice of antiepileptic drugs is also determined by side-effects,tolerability, drug interactions and pharmacokinetic profiles.