title: Epilepsy in a rural elderly population.
abstract: OBJECTIVE
  The first goal of this study was to describe the characteristics of elderly patients with epilepsy and the antiepileptic drugs used to treat them. Next, the factors (such as epilepsy type, seizure frequency, medical comorbidities, etc.) influencing antiepileptic drug choice and living situation were explored.
  
  
  METHODS
  Retrospective chart review of patients older than 70 with epilepsy seen in a rural health care system. This yielded 449 patients with epilepsy, 54 patients with isolated seizures and 38 patients with syncope as the primary diagnosis.
  
  
  RESULTS
  The most commonly used antiepileptic drug was phenytoin. New generation AED's which had fewer side effects were used much less frequently than old generation AED's but the probability of using new generation AED's was increased in patients with renal failure and congestive heart failure as well as in patients that had seen a neurologist. Patients with acute symptomatic seizures, dementia, chronic obstructive pulmonary disease, frequent seizures and advanced age were less likely to be independent. Patients that had seen a neurologist as an outpatient were more likely to live independently.
  
  
  CONCLUSIONS
  The elderly are a vulnerable population because of difficulty communicating their symptoms and their needs. This leads to the suboptimal use of AED's as well as poor outcomes. Careful attention to seizure control and medication side effects is critical in promoting good outcomes in this patient group. This retrospective study suggests that access of elderly patients with epilepsy to specialty care improves outcomes in terms of living status. This important information needs to be confirmed by prospective studies.
authors: Department of Neurology, Geisinger Medical Center, Danville, PA 17822, USA.
authors: Mona
authors: M
authors: Baran
authors: Mark M
authors: MM
authors: Stecker
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000706:statistics & numerical data*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004363:Drug Utilization; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012424:Rural Population; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants