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Semin Neurol 2008; 28(3): 336-341
DOI: 10.1055/s-2008-1079338
© Thieme Medical Publishers

Epilepsy in the Elderly

Gina Mapes Jetter1 , Jose E. Cavazos2 , 3
  • 1Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
  • 2Departments of Neurology, Pharmacology, and Physiology, and South Texas Comprehensive Epilepsy Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas
  • 3Audie L. Murphy Veterans Administration Medical Center, San Antonio, Texas
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Publication History

Publication Date:
24 July 2008 (online)

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ABSTRACT

There are many unique characteristics in elderly patients with epilepsy. The incidence of seizure in this age group is the highest of any age group and continues to increase as people live longer. Etiology of seizures is different than for adults and includes cerebrovascular disease, dementia, closed head injury, and metabolic encephalopathies. The elderly patient with epilepsy most often presents with complex partial seizures that have a higher recurrence rate than the younger population. The seizures are often difficult to diagnose since they present with atypical symptoms, particularly prolonged postictal symptoms, including memory lapses, confusion, altered mental status, and inattention. There are also therapeutic challenges due to age-related changes in pharmacokinetics, including variations in absorption, distribution, metabolism, and excretion. These must be considered when selecting antiepileptic drug (AED) therapy to avoid harmful side effects. In addition, several of the AEDs have drug-drug interactions, a problem potentially exacerbated in this population of patients due to the use of medications for comorbid conditions.

KEYWORDS

Epilepsy - geriatrics - antiepileptic drugs

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Jose E CavazosM.D. Ph.D. 

Department of Neurology, University of Texas Health Science Center at San Antonio

7703 Floyd Curl Drive, MC 7883, San Antonio, TX 78229

Email: cavazosj@uthscsa.edu