Epilepsy in older adults: causes, consequences and treatment.
OBJECTIVE
Seizures and epilepsy are common problems in older adults. Although, the highest incidence of seizures and epilepsy occurs in individuals more than 65 years of age, the magnitude of this public health problem, and its consequences on the quality of life of older adults, are not appreciated. Moreover, there is no consensus on the most appropriate way to diagnose or manage epilepsy in this population. This report reviews the current literature on all aspects of epilepsy in older people.


METHODS
The medical literature was reviewed for all articles pertaining to pathophysiology, diagnosis, and treatment of epilepsy in older people.


RESULTS
Epidemiology, etiology, diagnosis, use of diagnostic tests including EEG and imaging, new medical and surgical treatments, and psychosocial issues as they relate to older epilepsy patient are discussed. Several questions that merit future systematic investigation are presented.


CONCLUSIONS
Seizures and epilepsy in older people are much more common than is generally known. There are unique issues related to this population with regard to diagnosis and treatment. Several new medical and surgical therapies are now available for all epilepsy patients, some of which may be helpful for the older epilepsy patient.
Jefferson Comprehensive Epilepsy Center, Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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Sirven
D000368:Aged; D000927:Anticonvulsants / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging
D000927:Anticonvulsants