[Epilepsy in the elderly].
Although epilepsy was believed to have the highest incidence in childhood, recent epidemiologic studies revealed that the incidence increases markedly in elderly. At least 1% of elderly people are estimated to have epilepsy. Cerebrovascular disease is the most common underlying cause although 25% of new onset geriatric epilepsy cases have no obvious etiology. The most common seizure manifestation is atypical complex partial seizures with long-lasting postictal confusion which may lead to underdiagnosis and misdiagnosis. Factors complicating the treatment of geriatric epilepsy include comorbidities, drug interactions due to polytherapy, and aging-related changing of pharmacokinetics. Individualization of dosage and avoidance of unnecessary polypharmacy are essential for safe utilization of anti-epileptic drugs. New generation drugs such as gabapentin and levetiracetam are better tolerated for elderly people.
Yoshino
Aihide
A
Department of Psychiatry, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Japan. aihide@ndmc.ac.jp
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism; D000588:Amines / Q000008:administration & dosage; D000927:Anticonvulsants / Q000008:administration & dosage; D002561:Cerebrovascular Disorders / Q000150:complications / Q000453:epidemiology; D015897:Comorbidity; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004347:Drug Interactions; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D000077206:Gabapentin; D006801:Humans; D000077287:Levetiracetam; D010599:Pharmacokinetics; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage
D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D000077287:Levetiracetam; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D010889:Piracetam