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Epilepsy in older people

Published online by Cambridge University Press:  13 April 2015

Nicola Smith  and
Divya Tiwari
Nicola Smith
Affiliation:
Department of Medicine and Geriatrics, TheRoyal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Dorset, UK
Divya Tiwari*
Affiliation:
Department of Medicine and Geriatrics, TheRoyal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Dorset, UK
*
Address for correspondence: Dr Divya Tiwari, The Royal Bournemouth and Christchurch Hospitals Foundation Trust, Castle Lane East, Bournemouth BH7 7DW. Email: dtiwari@doctors.org.uk
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Summary

Epilepsy is the third most common neurological disorder of older adults, with huge functional and psychological implications. It is often difficult to diagnose in the presence of cognitive impairment and lack of a witness account. The most common identifiable causes of epilepsy in old age are cerebrovascular disease and dementia. New guidelines recommend starting treatment after first unprovoked seizure. If there is any doubt about the diagnosis, electroencephalography (EEG) should be considered, or ‘wait and watch’. The aim of treatment should be to fully control seizure activity with the most effective monotherapy and fewest possible side-effects. Drug compliance is often difficult to achieve in older adults.

Keywords

epilepsyseizureanti-epileptic drugsolder adults
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 25 , Issue 1 , February 2015 , pp. 53 - 59
Copyright
Copyright © Cambridge University Press 2015 

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References

Wallace, H, Shorvan, S, Tallis, R. Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy. The Lancet 1998; 352: 1790–93.Google Scholar
Berg, AT, Berkovic, SF, Brodie, MJ, Buchhalter, J, Cross, JH, Van Emde Boas, W, Engel, J, French, J, Glauser, TA, Mathern, GW, Moshé, SL, Nordli, D, Plouin, P, Scheffer, IE. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia 2010; 51: 676Google Scholar
Scadding, J, Losseff, N. Clinical Neurology, 4th edn. London, Hodder Arnold; 2012.Google Scholar
Stephen, LJ, Brodie, M. Epilepsy in elderly people. The Lancet 2000; 355: 1441–46.Google Scholar
De La Court, A, Breteler, MM, Meinhardi, Het al.Prevalence of epilepsy in the elderly: the Rotterdam study. Epilepsia 1996; 37: 141–47.CrossRefGoogle ScholarPubMed
Mendez, M, Lim, G. Seizures in elderly patients with dementia: epidemiology and management. Drugs Aging 2003; 20: 791–803.CrossRefGoogle Scholar
Delorenzo, RJ, Hauser, WA, Towne, ARet al.A prospective population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 1996; 46: 1029–35.Google Scholar
NHS Information Centre. Hospital Episode Statistics. Available at: http://www.hscic.gov.uk/catalogue/PUB02570/hosp-epis-stat-admi-prim-diag-4cha-10–11-tab.xls.Google Scholar
Rowan, AJ, Ramsay, RE, Collins, JFet al.VA Cooperative Study 428 group. New onset geriatric epilepsy: a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology 2005; 64: 1868–73.Google Scholar
Burn, J, Dennis, M, Bamford, Jet al.Epileptic seizures after a first stroke: the Oxfordshire community stroke project. BMJ 1997; 315: 1582–87.Google Scholar
Collins, N, Shapiro, RA, Ramsay, REet al.Elders with epilepsy. Medical Clinics of North America 2006; 90: 945–66.Google Scholar
Lancman, ME, Golimstok, A, Norscini, J, Granillo, R. Risk factors for developing seizures after a stroke. Epilepsia 1993; 34: 141–43.CrossRefGoogle ScholarPubMed
Cleary, P, Shorvon, S, Tallis, R. Late-onset seizures as a predictor of subsequent stroke. The Lancet 2004; 363: 1184–86.Google Scholar
Hesdorffer, DC, Hauser, WA, Annegers, JF, Kokmen, E, Rocca, WA. Dementia and adult unprovoked seizures. Neurology 1996; 46: 727–30.Google Scholar
Hiyoshi, T, Yagi, K. Epilepsy in the elderly. Epilepsia 2000; 41: 31–35.Google Scholar
Roberts, M, Godfrey, J, Caird, F. Epileptic seizures in the elderly: I. Aetiology and type of seizures. Age and Ageing 1982; 11: 24–28.Google Scholar
Annegers, I, Hausen, W, Coan, SP, Rocca, WA. A population-based study of seizures after traumatic brain injuries. N Engl J Med 1998; 338: 20–24.Google Scholar
Epilepsy in later life: A good practice guide. Glasgow, Epilepsy Scotland; 2008.Google Scholar
NICE. The Epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. NICE clinical guideline 137. London, National Clinical Guideline Centre 2012. Available at: nice.org.uk/guidance/cg137.Google Scholar
Marson, A, Jacoby, A, Johnson, A, Kim, L, Gamble, C, Chadwick, D. Immediate versus deferred antiepileptic drug treatment for early epilepsy and single seizures: a randomised controlled trial. The Lancet 2005; 365: 2007–13.Google Scholar
Ramsay, RE, Rowan, AJ, Pryor, FM. Special considerations in treating the elderly patient with epilepsy. Neurology 2004; 9: S24–29.Google Scholar
Bagshaw, J, Crawford, P, Chappell, B. Care in people 60 years of age and over with chronic or recently diagnosed epilepsy: a note review in United Kingdom general practice. Seizure 2009; 18: 57–60.Google Scholar
Schmidt, D, Schachter, SC. Drug treatment of epilepsy in adults. BMJ 2014; 348: 254.Google Scholar
Brodie, MJ, Overstall, PW, Giorgi, L. Multicentre, double-blind, randomised comparison between lamotrigine and carbamazepine in elderly patients with newly diagnosed epilepsy. Epilepsy Research 1999; 37: 81–87.Google Scholar
Saetre, E, Perucca, E, Isojärvi, Jet al.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: 1292–302.Google Scholar
www.epilepsysociety.org.ukGoogle Scholar
https://www.gov.uk/driving-medical-conditionsGoogle Scholar
Haut, S, Katz, M, Majur, J, Lipton, RB. Seizures in the elderly: impact on mental status, mood and sleep. Epilespy Behav 2009; 14: 540–44.Google Scholar