Head injury as provocative factor for epilepsy in the elderly

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.

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How to recognize treat and epilepsy in the elderly

MOJ Gerontology & Geriatrics ◽

10.15406/mojgg.2019.04.00201 ◽

2019 ◽

Vol 4 (5) ◽

Author(s):

Ana Paula Ferreira Silva Sakai ◽

Claudia Pinheiro Salles Gomes Rego

Keyword(s):

The Elderly ◽

Epilepsy In The Elderly

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Etiological prevalence of epilepsy and epileptic seizures in hospitalized elderly in a Brazilian tertiary center – Salvador - Brazil

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20140217 ◽

2015 ◽

Vol 73 (2) ◽

pp. 83-89 ◽

Cited By ~ 8

Author(s):

Telma Rocha de Assis ◽

Aroldo Bacellar ◽

Gersonita Costa ◽

Osvaldo J. M. Nascimento

Keyword(s):

Ischemic Stroke ◽

Statistical Significance ◽

Epileptic Seizures ◽

The Elderly ◽

Metabolic Disturbances ◽

Hospitalized Elderly ◽

Epilepsy In The Elderly ◽

Tertiary Center ◽

Elderly Inpatients ◽

Common Etiology

Epilepsy in the elderly has high incidence and prevalence and is often underecognized. Objective To describe etiological prevalence of epilepsy and epileptic seizures in elderly inpatients. Methods Retrospective analysis was performed on elderly patients who had epilepsy or epileptic seizures during hospitalization, from January 2009 to December 2010. One hundred and twenty patients were enrolled. They were divided into two age subgroups (median 75 years) with the purpose to compare etiologies. Results The most common etiology was ischemic stroke (36.7%), followed by neoplasias (13.3%), hemorrhagic stroke (11.7%), dementias (11.4%) and metabolic disturbances (5.5%). The analysis of etiological association showed that ischemic stroke was predominant in the younger subgroup (45% vs 30%), and dementias in the older one (18.9% vs 3.8%), but with no statistical significance (p = 0.23). Conclusion This study suggests that epilepsy and epileptic seizures in the elderly inpatients have etiological association with stroke, neoplasias and dementias.

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