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[Epileptic Seizures in the Elderly]

Overview
Journal Nervenarzt
Specialty Neurology
Date 2009 Mar 28
PMID 19326091
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Abstract

Given current demographic trends, the prevalence of epilepsy in the elderly population will increase. This review summarizes the most relevant clinical and therapeutic findings in elderly patients with epilepsy. Guidelines, systematic reviews, and meta-analysis are lacking, and there are only three randomized controlled trials of epilepsy in the elderly. Clinically, seizures in the elderly may be overlooked since warning signs (auras) and seizure evolution into generalized tonic-clonic seizures are rarer in old people. Sudden loss of consciousness occurs more frequently with increasing age, challenging differential diagnosis. Therapy is more complex due to frequent comorbidities and multiple drug therapies, requiring a cautious approach. Especially drug interactions need to be considered. Epileptic seizures seem to be better controlled by drugs in the elderly than in young people. Therapy is hampered by side effects and drug interactions, making definite diagnosis indispensable and bringing on the need for newer-generation antiepileptic drugs.

References
1.
Manford M, Fish D, Shorvon S . An analysis of clinical seizure patterns and their localizing value in frontal and temporal lobe epilepsies. Brain. 1996; 119 ( Pt 1):17-40. DOI: 10.1093/brain/119.1.17. View

2.
Ramsay R, Rowan A, Pryor F . Special considerations in treating the elderly patient with epilepsy. Neurology. 2004; 62(5 Suppl 2):S24-9. DOI: 10.1212/wnl.62.5_suppl_2.s24. View

3.
Olafsson E, Ludvigsson P, Gudmundsson G, Hesdorffer D, Kjartansson O, Hauser W . Incidence of unprovoked seizures and epilepsy in Iceland and assessment of the epilepsy syndrome classification: a prospective study. Lancet Neurol. 2005; 4(10):627-34. DOI: 10.1016/S1474-4422(05)70172-1. View

4.
Hauser W . Seizure disorders: the changes with age. Epilepsia. 1992; 33 Suppl 4:S6-14. DOI: 10.1111/j.1528-1157.1992.tb06222.x. View

5.
Saetre E, Perucca E, Isojarvi J, Gjerstad L . An international multicenter randomized double-blind controlled trial of lamotrigine and sustained-release carbamazepine in the treatment of newly diagnosed epilepsy in the elderly. Epilepsia. 2007; 48(7):1292-302. DOI: 10.1111/j.1528-1167.2007.01128.x. View